Victoria Meadows LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

VICTORIA MEADOWS LLC

Practice address

140908 Elk Haven Way
Crescent Lake, OR 97733-7069

Phone

(541) 433-2435

NPI assigned

Nov 14, 2024

Last updated

Nov 14, 2024By 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

Joseph Cole McGowan

Title

Program Director

Phone

(415) 590-0440

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1922822071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 NE HIGHWAY 20 STE 610-365",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016402",
            "telephone_number": "541-433-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140908 ELK HAVEN WAY",
            "city": "CRESCENT LAKE",
            "state": "OR",
            "postal_code": "977337069",
            "telephone_number": "541-433-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA MEADOWS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "MCGOWAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "COLE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "415-590-0440"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Cascades Fire & EMS
• Jaime Simmons

• Substance Abuse Rehabilitation Facility in Crescent Lake, OR
• Providers in Crescent Lake, OR by specialty
• Substance Abuse Rehabilitation Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.