Grants Pass Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRANTS PASS ASSISTED LIVING LLC

Practice address

201 SW Bridge St
Grants Pass, OR 97526-2925

Phone

(541) 956-2110

Fax

(541) 976-2109

NPI assigned

Jun 18, 2020

Organization subpart

No

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

Authorized official

Name

Todd Monroe Woollard

Title

Managing Member

Phone

(541) 956-2110

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Bridge Assisted Living Doing business as

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1972129690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SW BRIDGE ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262925",
            "telephone_number": "541-956-2110",
            "fax_number": "541-976-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SW BRIDGE ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262925",
            "telephone_number": "541-956-2110",
            "fax_number": "541-976-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANTS PASS ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "WOOLLARD",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "MONROE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "541-956-2110"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509759",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Bridge Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Grants Pass, OR
• Providers in Grants Pass, 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 18, 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.