NPIMap

Organization Active NPI

Live. Grow. Share. LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Eugene, OR
National Provider Identifier
1235819970
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
LIVE. GROW. SHARE. LLC
Practice address
1966 Garden Ave
Eugene, OR 97403-1933
Phone
(541) 505-9190
Fax
(541) 505-9264
NPI assigned
Jul 18, 2023
Last updated
Dec 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
LIVE. GROW. SHARE. LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Authorized official

Name
Kendra Stidhem, PSSNPI 1487146643
Title
Director of Outpatient Services
Phone
(541) 505-9190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1966 Garden Ave
Eugene, OR 97403-1933

Mailing address

1966 Garden Ave
Eugene, OR 97403-1933
Phone (541) 505-9190

Other practice location 1

87750 Charlet Dr
Eugene, OR 97402-9151
Phone (541) 505-9190

Other practice location 2

28517 Restwell Rd
Eugene, OR 97402-9033
Phone (541) 505-9190

National Provider Directory

National Provider Directory
Tax ID family
Live Grow Share LLC2 organizations share this tax ID, including this one
Part of
Live Grow Share LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

315 Coburg Rd
Ste C
Eugene, OR 97401
Phone (541) 505-9190

Practitioners & affiliated clinicians

Practitioners 68

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1235819970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1966 GARDEN AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031933",
            "telephone_number": "541-505-9190",
            "fax_number": "541-505-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1966 GARDEN AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031933",
            "telephone_number": "541-505-9190",
            "fax_number": "541-505-9264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87750 Charlet Dr",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974029151",
            "country_code": "US",
            "telephone_number": "541-505-9190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28517 Restwell Rd",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974029033",
            "country_code": "US",
            "telephone_number": "541-505-9190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIVE. GROW. SHARE. LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVE. GROW. SHARE. LLC",
        "enumeration_date": "2023-07-18",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "STIDHEM",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "DIRECTOR OF OUTPATIENT SERVICES",
        "authorized_official_telephone_number": "541-505-9190",
        "authorized_official_credential": "PSS"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.