Elderhealth & Living

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

516389 Issued in OR

Legal business name

ELDERHEALTH & LIVING

Practice address

382 S 58TH St
Springfield, OR 97478-7623

Phone

(541) 747-4858

Fax

(541) 747-8314

NPI assigned

Sep 24, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Nancy J Koll

Title

Cfo

Phone

(541) 747-4858

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Summit South Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dawn M Brown, FNP

  • Family Nurse Practitioner
  • Springfield, OR
  • NPI 1891734000
  NPD

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1912258443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S 58TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974787623",
            "telephone_number": "541-747-4858",
            "fax_number": "541-747-8314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 S 58TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974787623",
            "telephone_number": "541-747-4858",
            "fax_number": "541-747-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERHEALTH & LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-24",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "KOLL",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "541-747-4858",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": "516389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "516389",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dawn Edwards
• Deborah W Egbert, MD
• Sean Egglestone, REGISTERED DIETITIAN
• Erin Mary Ehly, R.N., B.S.N.
• Thomas Joseph Eivers, PHARMD
• Elderhealth & Living, Corporation
• Elham Y Elebiary, RPH
• Simone Elke Elias
• Abigail Eller, LPN
• Riley Ellington

• Mental Illness Community Based Residential Treatment Facility in Springfield, OR
• Providers in Springfield, OR by specialty
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.