Fox River Assisted Living & Memory Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FOX RIVER ASSISTED LIVING & MEMORY CARE, LLC

Doing business as

Fox River

Practice address

5800 Pennsylvania Ave
Appleton, WI 54914

Phone

(920) 997-0725

NPI assigned

May 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

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

• Fox River Doing business as

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467674507",
    "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": "97302",
            "telephone_number": "503-485-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 PENNSYLVANIA AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54914",
            "telephone_number": "920-997-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX RIVER ASSISTED LIVING & MEMORY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fox River",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Appleton, WI
• Providers in Appleton, WI by specialty
• Assisted Living Facility in Wisconsin

• 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.