Medford Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MEDFORD ASSISTED LIVING LLC

Doing business as

The Orchards Assisted Living

Practice address

1018 Royal CT
Medford, OR 97504-6175

Phone

(541) 773-2771

Fax

(541) 776-5227

NPI assigned

Jun 18, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Todd Monroe Woollard

Title

Managing Member

Phone

(541) 601-6070

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Orchards Assisted Living Doing business as

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1316563042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 ROYAL CT",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046175",
            "telephone_number": "541-773-2771",
            "fax_number": "541-776-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 ROYAL CT",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046175",
            "telephone_number": "541-773-2771",
            "fax_number": "541-776-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "WOOLLARD",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "MONROE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "541-601-6070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504356",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Orchards Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Medford, OR
• Providers in Medford, 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 Jun 18, 2020; 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.