Stayton SW Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

STAYTON SW ASSISTED LIVING LLC

Doing business as

Lakeside Assisted Living Community

Practice address

2201 3Rd Avenue
Stayton, OR 97383-1388

Phone

(503) 769-3200

NPI assigned

Mar 25, 2007

Organization subpart

No

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

Authorized official

Name

Jon M Harder

Title

Manager

Phone

(503) 485-4600

Specialties & licenses 2

Addresses

Other names 1

• Lakeside Assisted Living Community Doing business as

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1689791485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3006",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973020006",
            "telephone_number": "503-375-9016",
            "fax_number": "503-485-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 3RD AVENUE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831388",
            "telephone_number": "503-769-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAYTON SW ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "1769313990",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christian Lee Spencer, P.A.
• Stayton Chiropractic, LLC
• Stayton Family Practice Inc
• Stayton Family Practice LLC
• Stayton Pharmacy, LLC
• Elizabeth Stefan, RPH
• Heather Stinger
• Henry Frank Storey, O.D.
• Nicolas J Stratton, M.D.
• Charles Stringham, M.D.

• Assisted Living Facility in Stayton, OR
• Providers in Stayton, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.