Eagle Springs Specialized Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

BH 1370 Issued in WA

Legal business name

EAGLE SPRINGS SPECIALIZED CARE, LLC

Doing business as

Eagle Springs Memory Care Community

Practice address

20 SE Larch Ave
College Place, WA 99324-1199

Phone

(509) 525-6335

NPI assigned

Mar 31, 2007

Organization subpart

No

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

Authorized official

Name

Jon Harder

Title

Manager

Phone

(503) 485-4600

Specialties & licenses 1

Addresses

Other names 1

• Eagle Springs Memory Care Community Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467572495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE STE 270",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024975",
            "telephone_number": "503-485-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SE LARCH AVE",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993241199",
            "telephone_number": "509-525-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE SPRINGS SPECIALIZED CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "BH 1370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Springs Memory Care Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in College Place, WA
• Providers in College Place, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.