Ahr la Grande Or Alf TRS Sub, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AHR LA GRANDE OR ALF TRS SUB, LLC

Doing business as

Wildflower Lodge Assisted Living Community

Practice address

508 16TH St
La Grande, OR 97850-4400

Phone

(541) 605-5629

Fax

(541) 962-0242

NPI assigned

Nov 15, 2024

Last updated

Nov 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Candis Willis

Title

Quality & Wellness Director

Phone

(541) 636-3460

Specialties & licenses 1

Addresses

Other names 1

• Wildflower Lodge Assisted Living Community Doing business as

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1235954256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 16TH ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978504400",
            "telephone_number": "541-605-5629",
            "fax_number": "541-962-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 16TH ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978504400",
            "telephone_number": "541-605-5629",
            "fax_number": "541-962-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHR LA GRANDE OR ALF TRS SUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "CANDIS",
        "authorized_official_title_or_position": "QUALITY & WELLNESS DIRECTOR",
        "authorized_official_telephone_number": "541-636-3460"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wildflower Lodge Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in La Grande, OR
• Providers in La Grande, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.