3723 Fairview Industrial

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

3723 FAIRVIEW INDUSTRIAL

Practice address

1770 NW Valley View Dr
Roseburg, OR 97470-1778

Phone

(541) 673-3900

NPI assigned

Mar 25, 2007

Last updated

Jun 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jon Harder

Title

Manager

Phone

(503) 485-4600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1760509558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE STE 270",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024975",
            "telephone_number": "503-485-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 NW VALLEY VIEW DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701778",
            "telephone_number": "541-673-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3723 FAIRVIEW INDUSTRIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Roseburg, OR
• Providers in Roseburg, 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 13, 2008; 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.