Green Valley Memory Associates, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GREEN VALLEY MEMORY ASSOCIATES, LLC

Practice address

2985 S Camino del Sol
Green Valley, AZ 85622-8292

Phone

(520) 393-0077

NPI assigned

Jun 22, 2020

Organization subpart

No

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

Authorized official

Name

Gregory Roderick

Title

Member

Phone

(503) 443-1818

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Canyon Valley Memory Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1265058671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 SW BRIDGEPORT RD STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247790",
            "telephone_number": "503-597-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2985 S CAMINO DEL SOL",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856228292",
            "telephone_number": "520-393-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN VALLEY MEMORY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-443-1818"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "885095",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Valley Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Antonio Jose Luis Gonzalez
• Julia Frances Granone, DPM
• Green Valley Chiropractic Center Inc.
• Green Valley Dental Specialties
• Green Valley Family Care
• Green Valley Physical Medicine, Inc
• Colleen M Green, PMHNP-BC
• Vicki L Greiff, MD
• Kathy Lynn Grindle, RN
• Garth Gruenhagen, COTA

• Assisted Living Facility in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.