Skylark Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1121496081 Issued in OR

Legal business name

SKYLARK ASSISTED LIVING LLC

Practice address

900 Skylark PL
Ashland, OR 97520-9640

Phone

(541) 552-1713

Fax

(541) 552-1058

NPI assigned

Sep 4, 2014

Organization subpart

No

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

Authorized official

Name

Todd M Woollard

Title

Ceo

Phone

(541) 552-1713

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1336540798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SKYLARK PL",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975209640",
            "telephone_number": "541-552-1713",
            "fax_number": "541-552-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SKYLARK PL",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975209640",
            "telephone_number": "541-552-1713",
            "fax_number": "541-552-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLARK ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "WOOLLARD",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-552-1713"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "1121496081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502827",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Ashland, OR
• Providers in Ashland, 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 Sep 4, 2014; 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.