NPIMap

Organization Active NPI

Shangri-la Corporation

  • Mental Illness Community Based Residential Treatment Facility
  • Salem, OR
National Provider Identifier
1922352376
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
SHANGRI-LA CORPORATION
Practice address
4080 Reed Rd SE Ste 150
Salem, OR 97302-1335
Phone
(503) 581-1732
Fax
(503) 316-2299
NPI assigned
Nov 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Authorized official

Name
Robin Lenay Winkle
Title
Director
Phone
(503) 581-1732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X OR Primary

Addresses

Primary practice location

4080 Reed Rd SE Ste 150
Salem, OR 97302-1335

Mailing address

4080 Reed Rd SE Ste 150
Salem, OR 97302-1335
Phone (503) 581-1732

Other identifiers 1

IdentifierTypeStateIssuer
516845OtherORDMAP PROVIDER #

Other names 1

  • Via Verde Other name

National Provider Directory

National Provider Directory
Tax ID family
The Shangri-la Corporation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

4080 Reed Rd SE
Ste 150
Salem, OR 97302
Phone (503) 581-1732

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1922352376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 REED RD SE STE 150",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021335",
            "telephone_number": "503-581-1732",
            "fax_number": "503-316-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 REED RD SE STE 150",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021335",
            "telephone_number": "503-581-1732",
            "fax_number": "503-316-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANGRI-LA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "WINKLE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "LENAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "503-581-1732"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMAP PROVIDER #",
            "identifier": "516845",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Via Verde",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Via Verde",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.