NPIMap

Organization Active NPI

Elderly and Disabled Services

  • Assisted Living Facility (Behavioral Disturbances)
  • Medford, OR
National Provider Identifier
1447007752
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X
Legal business name
ELDERLY AND DISABLED SERVICES
Practice address
2021 Jubilant Ave
Medford, OR 97504-4755
Phone
(541) 500-1688
NPI assigned
May 3, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Authorized official

Name
Larry Michael McPhee
Title
Owner/ Provider
Phone
(541) 261-1991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X Primary

Addresses

Primary practice location

2021 Jubilant Ave
Medford, OR 97504-4755

Mailing address

3126 State St Ste 100
Medford, OR 97504-8665
Phone (541) 261-1991

Other names 1

  • Restoration Home Jubilant AFH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elderly and Disabled Services7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1447007752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 STATE ST STE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048665",
            "telephone_number": "541-261-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 JUBILANT AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044755",
            "telephone_number": "541-500-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERLY AND DISABLED SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "MCPHEE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/ PROVIDER",
        "authorized_official_telephone_number": "541-261-1991"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoration Home Jubilant AFH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.