Redmond Alf, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

REDMOND ALF, LLC

Doing business as

Brookside Place

Practice address

3550 SW Canal Blvd
Redmond, OR 97756-8947

Phone

(541) 504-1600

NPI assigned

Jun 11, 2020

Last updated

Jun 11, 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

Peter Verdieck

Title

Evp Finance & Administration

Phone

(503) 255-4647

Specialties & licenses 1

Addresses

Other names 1

• Brookside Place 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

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1922623206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15900 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159502",
            "telephone_number": "503-255-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 SW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977568947",
            "telephone_number": "541-504-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDMOND ALF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "VERDIECK",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "EVP FINANCE & ADMINISTRATION",
        "authorized_official_telephone_number": "503-255-4647"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Redmond, OR
• Providers in Redmond, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.