Active NPI
TLC West, L.L.C.
- Point of Service
- Salem, OR
National Provider Identifier
1396958658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Point of Service
- Legal business name
- TLC WEST, L.L.C.
- Practice address
- 3220 State St
Suite 200
Salem, OR 97301-6872 - Phone
- (506) 566-5715
- Fax
- (503) 588-3531
- NPI assigned
- May 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kelley D Hamilton
- Title
- Ceo-Pres of Manager
- Phone
- (503) 566-5715
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Point of Service | 305S00000X | OR | Primary |
Addresses
Primary practice location
3220 State St
Suite 200
Salem, OR 97301-6872
Mailing address
1615 Brush College Rd NW
Salem, OR 97304-1400
Phone (503) 361-8599
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 515260-86 | Other | OR | REGISTRY # |
Other names 1
- Gibson Creek Retirement & Assisted Living Facility
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1191456000000",
"number": "1396958658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 BRUSH COLLEGE RD NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973041400",
"telephone_number": "503-361-8599",
"fax_number": "503-371-1160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3220 STATE ST",
"address_2": "SUITE 200",
"city": "SALEM",
"state": "OR",
"postal_code": "973016872",
"telephone_number": "506-566-5715",
"fax_number": "503-588-3531"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TLC WEST, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-07",
"last_updated": "2007-10-04",
"status": "A",
"authorized_official_last_name": "HAMILTON",
"authorized_official_first_name": "KELLEY",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CEO-PRES OF MANAGER",
"authorized_official_telephone_number": "503-566-5715",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "305S00000X",
"taxonomy_group": "",
"desc": "Point of Service",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTRY #",
"identifier": "515260-86",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Gibson Creek Retirement & Assisted Living Facility",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.