Care Center (Menlo Park) Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CARE CENTER (MENLO PARK) INC.

Doing business as

Prestige Care & Rehabilitation - Menlo Park

Practice address

745 NE 122ND Ave
Portland, OR 97230-2001

Phone

(503) 252-0241

NPI assigned

Aug 27, 2012

Organization subpart

No

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

Authorized official

Name

Gregory J Vislocky

Title

Ex VP of Finance / Partner

Phone

(360) 816-8295

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prestige Care & Rehabilitation - Menlo Park Doing business as

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1609124551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 NE PARKWAY DR",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626654",
            "telephone_number": "360-735-7155",
            "fax_number": "360-735-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302001",
            "telephone_number": "503-252-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE CENTER (MENLO PARK) INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "VISLOCKY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EX VP OF FINANCE / PARTNER",
        "authorized_official_telephone_number": "360-816-8295"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500648667",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Care & Rehabilitation - Menlo Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.