Evergreen Oregon Healthcare Orchards Retirement, L.L.C.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1883778809 Issued in OR

Legal business name

EVERGREEN OREGON HEALTHCARE ORCHARDS RETIREMENT, L.L.C.

Doing business as

Cascade Valley Assisted Living

Practice address

1010 NE 3Rd Ave
Milton Freewater, OR 97862-9404

Phone

(541) 938-5693

Fax

(541) 938-4490

NPI assigned

Sep 24, 2010

Last updated

Sep 23, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

EVERGREEN OREGON HEALTHCARE, L.L.C.As reported in NPPES

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

Authorized official

Name

Michael J Miller

Title

Assistant Manager

Phone

(360) 892-6628

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cascade Valley Assisted Living Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Divine Mansiba Maganto

  • Nurse's Aide
  • Milton Freewater, OR
  • NPI 1548890916
  NPD (past)

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1710296793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 NE 77TH AVE",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626729",
            "telephone_number": "360-892-6628",
            "fax_number": "360-882-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NE 3RD AVE",
            "city": "MILTON FREEWATER",
            "state": "OR",
            "postal_code": "978629404",
            "telephone_number": "541-938-5693",
            "fax_number": "541-938-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN OREGON HEALTHCARE ORCHARDS RETIREMENT, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERGREEN OREGON HEALTHCARE, L.L.C.",
        "enumeration_date": "2010-09-24",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ASSISTANT MANAGER",
        "authorized_official_telephone_number": "360-892-6628"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "1883778809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "564166",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Valley Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Edward Destito, PHARMD
• Dynamic Edge Physical Therapy LLC
• Edson R Brewer (Northwest Hearing Consultants)
• Dinah Estraza Estrellanes, PT
• Evergreen Oregon Healthcare Orchards Rehabilitation, L.L.C. (Milton Freewater Health and Rehabilitation Center)
• Fire Inc
• Virginia Foreman, SLP
• Fresenius Medical Care Dialysis Services - Oregon, LLC (FMC Milton Freewater)
• Scott T Fry, M.D.
• Michael Lane Garton, O. D.

• Assisted Living Facility in Milton Freewater, OR
• Providers in Milton Freewater, 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 Sep 23, 2020; 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.