Sweet Home MC LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

SWEET HOME MC LLC

Doing business as

Wiley Creek Memory Care

Practice address

4950 Mountain Fir St
Sweet Home, OR 97386

Phone

(503) 391-9999

NPI assigned

Jan 26, 2024

Last updated

Jan 26, 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

Douglas Sproul

Title

Manageing Member

Phone

(503) 391-9999

Specialties & licenses 1

Addresses

Other names 1

• Wiley Creek Memory Care Doing business as

Locations

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1992567721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HAWTHORNE AVE SE STE 210",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015895",
            "telephone_number": "503-391-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 MOUNTAIN FIR ST",
            "city": "SWEET HOME",
            "state": "OR",
            "postal_code": "97386",
            "telephone_number": "503-391-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEET HOME MC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "SPROUL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "MANAGEING MEMBER",
        "authorized_official_telephone_number": "503-391-9999"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wiley Creek Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cayla Stoering, MA
• Michael Wayne Stoner, O.D.
• Shannon Marie Strubhar, CD(DONA)
• Sweet Home Clinic LLC (Ridgeway Health)
• Sweet Home Fire & Ambulance District
• Sweet Home School District 55
• Carla Tadewaldt, LMFT
• Ashley Nichole Tenbusch, RN
• Darren H Terry, PTA
• Randy L Townsend, LD

• Alzheimer Center (Dementia Center) in Sweet Home, OR
• Providers in Sweet Home, OR by specialty
• Alzheimer Center (Dementia Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.