Active NPI
Pacific Living Centers South, LLC
- Assisted Living Facility (Mental Illness)
- Grants Pass, OR
National Provider Identifier
1700530987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility (Mental Illness)
- Legal business name
- PACIFIC LIVING CENTERS SOUTH, LLC
- Practice address
- 1635 Kellenbeck Ave
Grants Pass, OR 97527-4247 - Phone
- (541) 474-6493
- NPI assigned
- Feb 7, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carl Mason
- Title
- Coo
- Phone
- (503) 826-5190
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | |||
| Assisted Living Facility (Mental Illness) | 3104A0625X | Primary |
Addresses
Primary practice location
1635 Kellenbeck Ave
Grants Pass, OR 97527-4247
Mailing address
25260 SW Parkway Ave Ste B
Wilsonville, OR 97070-6627
Phone (503) 826-5190
Other practice location 1
3465 Lone Pine Rd
Medford, OR 97504-5681
Phone (541) 245-9814
Other practice location 2
2268 Williams Hwy
Grants Pass, OR 97527-5670
Phone (541) 474-6399
Other practice location 3
820 Gold Ct
Grants Pass, OR 97527-4786
Phone (541) 474-7887
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8850499803 | Other | OR | DHS APD |
| 3246694719 | Other | OR | DHS APD |
| 5482307390 | Other | OR | DHS APD |
| 7715251304 | Other | OR | DHS APD |
Other names 4
- Applegate House of Grants Pass
- Arbor House of Grants Pass
- Autumn House of Grants Pass
- Bartlett House of Medford
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | admin@pacificlivingcenters.com | Direct |
National Provider Directory
National Provider DirectoryLocations
2268 Williams Hwy
Grants Pass, OR 97527
Phone (541) 474-6399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644192000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1744761600000",
"number": "1700530987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25260 SW PARKWAY AVE STE B",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970706627",
"telephone_number": "503-826-5190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 KELLENBECK AVE",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975274247",
"telephone_number": "541-474-6493"
}
],
"practiceLocations": [
{
"address_1": "3465 Lone Pine Rd",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "OR",
"postal_code": "975045681",
"country_code": "US",
"telephone_number": "541-245-9814",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2268 Williams Hwy",
"address_purpose": "LOCATION",
"city": "Grants Pass",
"state": "OR",
"postal_code": "975275670",
"country_code": "US",
"telephone_number": "541-474-6399",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "820 Gold Ct",
"address_purpose": "LOCATION",
"city": "Grants Pass",
"state": "OR",
"postal_code": "975274786",
"country_code": "US",
"telephone_number": "541-474-7887",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PACIFIC LIVING CENTERS SOUTH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-07",
"last_updated": "2025-04-16",
"certification_date": "2025-04-16",
"status": "A",
"authorized_official_last_name": "MASON",
"authorized_official_first_name": "CARL",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "503-826-5190"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHS APD",
"identifier": "8850499803",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHS APD",
"identifier": "3246694719",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHS APD",
"identifier": "5482307390",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHS APD",
"identifier": "7715251304",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "admin@pacificlivingcenters.com",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1635 Kellenbeck Ave",
"city": "Grants Pass",
"state": "OR",
"country_code": "US",
"postal_code": "975274247",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Applegate House of Grants Pass",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Arbor House of Grants Pass",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Autumn House of Grants Pass",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Autumn House of Grants Pass",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Bartlett House of Medford",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.