Maple Ridge Retirement & Assisted Living Community LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

1966 Issued in WA

Legal business name

MAPLE RIDGE RETIREMENT & ASSISTED LIVING COMMUNITY LLC

Doing business as

Maple Ridge Retirement & Assisted Living Community

Practice address

1767 Alliance Ave
Freeland, WA 98249-9448

Phone

(360) 331-1303

Fax

(360) 331-1363

NPI assigned

Nov 23, 2007

Last updated

Nov 23, 2007By 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

Mr. Kelley D Hamilton

Title

Ceo/President of Management Company

Phone

(503) 373-3125

Specialties & licenses 1

Addresses

Other names 1

• Maple Ridge Retirement & Assisted Living Community 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

Tax ID family

Maple Ridge Assisted Living Community2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Maple Ridge Assisted Living Community LLC

  dba Maple Ridge Assisted Living Community

  • Exclusive Provider Organization
  • Salem, OR
  • NPI 1275721268
  NPD tax ID

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195776000000",
    "number": "1871774455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 STATE ST",
            "address_2": "SUITE 200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973016872",
            "telephone_number": "503-373-3125",
            "fax_number": "503-588-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 ALLIANCE AVE",
            "city": "FREELAND",
            "state": "WA",
            "postal_code": "982499448",
            "telephone_number": "360-331-1303",
            "fax_number": "360-331-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE RIDGE RETIREMENT & ASSISTED LIVING COMMUNITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-23",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO/PRESIDENT OF MANAGEMENT COMPANY",
        "authorized_official_telephone_number": "503-373-3125",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WA",
            "license": "1966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maple Ridge Retirement & Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paula Ann Lintin, PHD, LPCC, LMHC
• Brenda Lee Litke, HIS
• Katelyn Lodell, MA
• Michael Lodell, DPT
• Kathryn H Luetkehans, LMHC
• Patricia Joy McMahon, M.ED, MA
• Bobbi Nichole Mennella, LMP
• Arden Meyer, LSWAIC
• MJ Best Chiropractic, Inc
• John E. Monroe, D.D.S.

• Point of Service in Freeland, WA
• Providers in Freeland, WA by specialty
• Point of Service in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.