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Organization Active NPI

Woodland Retirement & Assisted Living Communtiy LLC

Doing business as Woodland Retirement & Assisted Living Community

  • Point of Service
  • Salem, OR
National Provider Identifier
1740493931
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
1709 Issued in WA
Legal business name
WOODLAND RETIREMENT & ASSISTED LIVING COMMUNTIY LLC
Doing business as
Woodland Retirement & Assisted Living Community
Practice address
3220 State St
Suite 200
Salem, OR 97301-6872
Phone
(503) 566-5715
Fax
(503) 588-3531
NPI assigned
May 7, 2007
Last updated
Oct 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Mr. Kelley D Hamilton
Title
Ceo-Pres of Manager
Phone
(503) 566-5715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 1709 WA Primary

Addresses

Primary practice location

3220 State St
Suite 200
Salem, OR 97301-6872

Mailing address

4532 Intelco Loop SE
Lacey, WA 98503-5561
Phone (360) 528-3253

Other names 1

  • Woodland Retirement & Assisted Living Community Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1740493931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4532 INTELCO LOOP SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035561",
            "telephone_number": "360-528-3253",
            "fax_number": "360-528-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 STATE ST",
            "address_2": "SUITE 200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973016872",
            "telephone_number": "503-566-5715",
            "fax_number": "503-588-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND RETIREMENT & ASSISTED LIVING COMMUNTIY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO-PRES OF MANAGER",
        "authorized_official_telephone_number": "503-566-5715",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WA",
            "license": "1709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodland Retirement & Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; 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.