Oswego Memory Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

5103962 Issued in IL

Legal business name

OSWEGO MEMORY CARE, LLC

Doing business as

Autumn Leaves of Oswego

Practice address

900 Douglas Rd
Oswego, IL 60543-5120

Phone

(331) 454-7540

Fax

(331) 454-7541

NPI assigned

Jan 15, 2014

Last updated

Jan 15, 2014By 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

Mrs. Felichia Fields

Title

Vice President of Management--SL

Phone

(214) 845-4454

Specialties & licenses 1

Addresses

Other names 1

• Autumn Leaves of Oswego Doing business as

Tax ID family

Autumn Leaves of Oswego2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Oswego Memory Care, LLC

  • Assisted Living Facility
  • Oswego, IL
  • NPI 1932534484
  NPD tax ID

Locations

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1659793362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 E JOHN CARPENTER FWY",
            "address_2": "SUITE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623931",
            "telephone_number": "214-845-4500",
            "fax_number": "214-845-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 DOUGLAS RD",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605435120",
            "telephone_number": "331-454-7540",
            "fax_number": "331-454-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSWEGO MEMORY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "FELICHIA",
        "authorized_official_title_or_position": "VICE PRESIDENT OF MANAGEMENT--SL",
        "authorized_official_telephone_number": "214-845-4454",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "5103962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Leaves of Oswego",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Oswego Dental Group, LLC
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• Oswego Family Chiropractic Center, P.C.
• Oswego Family Physicians LTD
• Oswego Fire Protection District
• Oswego Memory Care, LLC
• Oswego Vision, LTD
• Oswego Wellness, Inc
• Robert Otto, D.M.D.
• Steven M Owczaruk, DMD

• Assisted Living Facility in Oswego, IL
• Providers in Oswego, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.