Park Place Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PARK PLACE ASSISTED LIVING LLC

Practice address

1930 E 12TH St
Casper, WY 82601-4075

Phone

(307) 265-2273

Fax

(503) 485-1279

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Jon M Harder

Title

Manager

Phone

(503) 485-4600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467585034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE",
            "address_2": "SUITE 270",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 E 12TH ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826014075",
            "telephone_number": "307-265-2273",
            "fax_number": "503-485-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley J Palmer, MD
• Tiffany Palmer
• Pamela Mills Physical Therapist LLC
• Wenyuan Lucy Pao, M.D.
• Crystal L Paredes, M.S., LPC
• Park Ridge Behavioral Healthcare, LLC
• Zackery Gilberto-Eagle Parkhurst
• Amanda M Parks, FNP-C
• Leanne E Parks, DPT
• Cynthia Ann Parrish, LPC

• Assisted Living Facility in Casper, WY
• Providers in Casper, WY by specialty
• Assisted Living Facility in Wyoming

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.