Edmond Memory Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5598-5598 Issued in OK

Legal business name

EDMOND MEMORY CARE, LLC

Doing business as

Autumn Leaves of Edmond

Practice address

1001 S Bryant Ave
Edmond, OK 73034-5745

Phone

(405) 341-1450

Fax

(405) 341-1451

NPI assigned

Jun 27, 2014

Organization subpart

No

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

Authorized official

Name

Christopher Rio

Title

VP of Management-Senior Living

Phone

(214) 845-4500

Specialties & licenses 1

Addresses

Other names 1

• Autumn Leaves of Edmond Doing business as

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403827200000",
    "number": "1871908913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 E JOHN CARPENTER FWY",
            "address_2": "SUITE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623931",
            "telephone_number": "214-845-4500",
            "fax_number": "214-845-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345745",
            "telephone_number": "405-341-1450",
            "fax_number": "405-341-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMOND MEMORY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-27",
        "last_updated": "2014-06-27",
        "status": "A",
        "authorized_official_last_name": "RIO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "VP OF MANAGEMENT-SENIOR LIVING",
        "authorized_official_telephone_number": "214-845-4500"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OK",
            "license": "AL5598-5598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Leaves of Edmond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Edmond, OK
• Providers in Edmond, OK by specialty
• Assisted Living Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.