Active NPI
Goodlettsville Al MC Care Properties, LLC
- Assisted Living Facility
- Goodlettsville, TN
National Provider Identifier
1467069807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- GOODLETTSVILLE AL MC CARE PROPERTIES, LLC
- Practice address
- 322 Northcreek Blvd
Goodlettsville, TN 37072-1998 - Phone
- (615) 712-1180
- NPI assigned
- Sep 29, 2020
- 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
- Gregory A Roderick
- Title
- Member
- Phone
- (503) 443-1818
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
322 Northcreek Blvd
Goodlettsville, TN 37072-1998
Mailing address
7420 SW Bridgeport Rd Ste 105
Portland, OR 97224-7790
Phone (503) 597-4906
Other names 1
- Jubilee Hills at Goodlettsville
National Provider Directory
National Provider DirectoryLocations
322 Northcreek Blvd
Goodlettsville, TN 37072
Phone (615) 712-1180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601337600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1601337600000",
"number": "1467069807",
"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": "322 NORTHCREEK BLVD",
"city": "GOODLETTSVILLE",
"state": "TN",
"postal_code": "370721998",
"telephone_number": "615-712-1180"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOODLETTSVILLE AL MC CARE PROPERTIES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-09-29",
"last_updated": "2020-09-29",
"certification_date": "2020-09-29",
"status": "A",
"authorized_official_last_name": "RODERICK",
"authorized_official_first_name": "GREGORY",
"authorized_official_middle_name": "A",
"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": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Jubilee Hills at Goodlettsville",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Goodlettsville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.