Elk Meadows Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2010-ALII-80781 Issued in UT

Legal business name

ELK MEADOWS ASSISTED LIVING, LLC

Practice address

4200 North 400 West
Oakley, UT 84055

Phone

(435) 783-5575

Fax

(435) 783-5588

NPI assigned

Jun 11, 2008

Last updated

Nov 8, 2011By 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

Mr. Steven Bae

Title

Director of Operations

Phone

(503) 675-3925

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1548420748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 NORTH 400 WEST",
            "city": "OAKLEY",
            "state": "UT",
            "postal_code": "84055",
            "telephone_number": "435-783-5575",
            "fax_number": "435-783-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 NORTH 400 WEST",
            "city": "OAKLEY",
            "state": "UT",
            "postal_code": "84055",
            "telephone_number": "435-783-5575",
            "fax_number": "435-783-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK MEADOWS ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "BAE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "503-675-3925",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "UT",
            "license": "2007-ALII-80781",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "UT",
            "license": "2010-ALII-80781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vernie Douglas Bodden Jr., MD
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• Suzanne Clark, MFTI, MA
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• Sidney Elizabeth Davis
• Evans Weiss, LLC Dba Tranquil Mind Counseling (Tranquil Mind Counseling)
• Lisa Hampshire, LCSW
• Innerchange Oakley, LLC
• Syau-Fu Ma, MD
• Roxi Nelson, LCSW

• Assisted Living Facility in Oakley, UT
• Providers in Oakley, UT by specialty
• Assisted Living Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.