Rest Harbor Extended Care Center Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

808550 Issued in OR

Legal business name

REST HARBOR EXTENDED CARE CENTER INC.

Doing business as

Rest Harbor Rehabilitation & Extended Care

Practice address

5905 SE Powell Valley Rd
Gresham, OR 97080-1919

Phone

(503) 665-1151

Fax

(503) 669-1986

NPI assigned

Jul 3, 2006

Last updated

Aug 22, 2020By 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. Greg Charles Dempsey, VICE PRESIDENT

Title

Administrator

Phone

(503) 665-1151

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rest Harbor Rehabilitation & Extended Care Doing business as

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881624112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801919",
            "telephone_number": "503-665-1151",
            "fax_number": "503-669-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801919",
            "telephone_number": "503-665-1151",
            "fax_number": "503-669-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REST HARBOR EXTENDED CARE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEMPSEY",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-665-1151",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "VICE PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": "808550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808550",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rest Harbor Rehabilitation & Extended Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Gresham, OR
• Providers in Gresham, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.