Organization Active NPI

Care Center (Milwaukie) Inc.

  • Skilled Nursing Facility
  • Milwaukie, OR
National Provider Identifier
1205204609
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CARE CENTER (MILWAUKIE) INC.
Doing business as
Prestige Post-Acute and Rehabilitation Center - Milwaukie
Practice address
12045 SE Stanley Ave
Milwaukie, OR 97222-2938
Phone
(503) 659-2323
NPI assigned
Sep 2, 2015
Organization subpart
Yes
Parent organization
PRESTIGE CARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gregory Vislocky
Title
Ex VP of Finance / Partner
Phone
(360) 735-7155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

12045 SE Stanley Ave
Milwaukie, OR 97222-2938

Mailing address

12045 SE Stanley Ave
Milwaukie, OR 97222-2938
Phone (503) 659-2323

Other identifiers 1

IdentifierTypeStateIssuer
500695377MedicaidOR

Other names 1

  • Prestige Post-Acute and Rehabilitation Center - Milwaukie Doing business as

National Provider Directory

National Provider Directory

Locations

12045 SE Stanley Ave
Portland, OR 97222
Phone (503) 659-2323

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1205204609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12045 SE STANLEY AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222938",
            "telephone_number": "503-659-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12045 SE STANLEY AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222938",
            "telephone_number": "503-659-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE CENTER (MILWAUKIE) INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESTIGE CARE, INC",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "VISLOCKY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "EX VP OF FINANCE / PARTNER",
        "authorized_official_telephone_number": "360-735-7155"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500695377",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Post-Acute and Rehabilitation Center - Milwaukie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.