RSL Gresham, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

RSL GRESHAM, LLC

Practice address

1655 NE 18TH St
Gresham, OR 97030-4113

Phone

(503) 665-1994

Fax

(503) 489-0283

NPI assigned

Jun 17, 2020

Organization subpart

Yes

Parent organization

RADIANT COMPANIES, INC.As reported in NPPES

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

Authorized official

Name

James Guffee

Title

President of Manager

Phone

(503) 595-2810

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• FARMINGTON SQUARE GRESHAM 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": "1592352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1760008684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 SW GREENBURG RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235505",
            "telephone_number": "503-595-2810",
            "fax_number": "503-595-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 NE 18TH ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304113",
            "telephone_number": "503-665-1994",
            "fax_number": "503-489-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSL GRESHAM, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIANT COMPANIES, INC.",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "GUFFEE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT OF MANAGER",
        "authorized_official_telephone_number": "503-595-2810"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522959",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENTIAL CARE FACILITY LICENSE",
            "identifier": "1046513855",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522960",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FARMINGTON SQUARE GRESHAM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lottie Renee Rotterman, AUD
• Tyson Roupp
• Elizabeth A Rowland, MS CCC SLP
• Margarita Sison Roxas, PHYSICAL THERAPIST
• Imma Royal, CSWA
• Arlo Roy Rudy
• Delia Yulisa Ruiz
• David William Rumer, COMS
• Elena Runyon
• Scott Alan Ruplin, MSW

• Assisted Living Facility in Gresham, OR
• Providers in Gresham, 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 Jun 17, 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.