Senior Haven LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SENIOR HAVEN LLC

Practice address

12140 SE Foster Rd
Portland, OR 97266-4043

Phone

(971) 271-8975

NPI assigned

May 8, 2020

Organization subpart

No

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

Authorized official

Name

Robert Austin Evans

Title

Managing Member

Phone

(541) 317-9188

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Senior Haven RCF Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588896000000",
    "number": "1700408010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1410",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977091410",
            "telephone_number": "541-317-9188",
            "fax_number": "541-389-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12140 SE FOSTER RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664043",
            "telephone_number": "971-271-8975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR HAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-08",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "541-317-9188"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164402",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Haven RCF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara Senffner, R.N.
• Florence Luciana Seng
• Matty Senghore
• Sidharth Krishnan Sengupta
• Margaret Senic
• Melissa Ann Senn-Reis, ATC
• Carrie Elizabeth Senn, PHARMD
• Jordan L Senn, DO
• Kevin Mark Senn, MD
• Sensory Kids, LLC

• Assisted Living Facility in Portland, OR
• Providers in Portland, 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 May 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.