Active NPI
Elite Care Grant LLC
- Assisted Living Facility
- Tigard, OR
National Provider Identifier
1871395491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- ELITE CARE GRANT LLC
- Practice address
- 12353 SW Grant Ave
Tigard, OR 97223 - Phone
- (503) 583-7937
- NPI assigned
- Mar 25, 2025
- 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
- Raeann Voorhies, RN
- Title
- Ceo
- Phone
- (503) 348-8587
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
12353 SW Grant Ave
Tigard, OR 97223
Mailing address
4444 SE Oatfield Hill Road
Milwaukie, OR 97267
Phone (503) 653-5656
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 529927 | Medicaid | OR |
Other names 1
- DBA Fanno Creek by Elite Care
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D2202390 | Fanno Creek by Elite Care | Certificate of waiver | Nov 24, 2026 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742860800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1742860800000",
"number": "1871395491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4444 SE OATFIELD HILL ROAD",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97267",
"telephone_number": "503-653-5656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12353 SW GRANT AVE",
"city": "TIGARD",
"state": "OR",
"postal_code": "97223",
"telephone_number": "503-583-7937"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE CARE GRANT LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-25",
"last_updated": "2025-03-25",
"status": "A",
"authorized_official_last_name": "VOORHIES",
"authorized_official_first_name": "RAEANN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "503-348-8587",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "529927",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "DBA Fanno Creek by Elite Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.