Canton Senior Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CANTON SENIOR LIVING, LLC

Practice address

125 Riverstone Ter
Canton, GA 30114-5218

Phone

(770) 720-9669

Fax

(503) 485-1279

NPI assigned

Apr 19, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Shirley Dunn

Title

Cro Representative

Phone

(503) 485-4948

Specialties & licenses 2

Addresses

Other names 1

• Terrace at Riverstone Doing business as

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1497071286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021177",
            "telephone_number": "503-485-8686",
            "fax_number": "503-485-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 RIVERSTONE TER",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145218",
            "telephone_number": "770-720-9669",
            "fax_number": "503-485-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON SENIOR LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "CRO REPRESENTATIVE",
        "authorized_official_telephone_number": "503-485-4948",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Terrace at Riverstone",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Canton Opco, LLC
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• Canton Orthopaedics and Sports Medicine, P.C.
• Canton Pediatric Dentistry PC
• Canton Physical Medicare, LLC
• Canton Smiles Dentistry, PC
• Canton Specialty Imaging, LLC
• Canton Wellness Center LLC
• Canton Wellness Center LLC
• Canton West Chiropractic

• Assisted Living Facility in Canton, GA
• Providers in Canton, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; 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.