JACKSON HOLE SENIOR LIVING, LLC (NPI# 1184811143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184811143 |
| Entity Type | Organization |
| Organization Name | JACKSON HOLE SENIOR LIVING, LLC |
| Other Organization Name | RIVER ROCK LODGE ASSISTED LIVING COMMUNITY |
| Practice Address |
3000 W Big Trail Dr Jackson Hole WY 83001-9138 |
| Mailing Address |
3723 Fairview Industrial Dr Se Salem OR 97302-1177 |
| Practice Telephone | 3077340500 |
| Mailing Telephone | 5033759016 |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2007-10-03 |
| Authorized Official Name | MR. JON M HARDER (MANAGER) |
| Authorized Official Telephone | 5033759016 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 08-035 | WY | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| River Rock Lodge Assisted Living Community | Doing Business As Name - Organization |
| Street Address |
3000 W BIG TRAIL DR |
| City | JACKSON HOLE |
| State | WY |
| Zip Code | 83001-9138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578035440 | Casper Independent Living, LLC | Assisted Living Facility | 77 Gardenia St, Casper, WY 82604-3803 | 2018-12-17 |
| 1437659877 | Mountain Lodge LLC | Assisted Living Facility | 1110 Birch St, Douglas, WY 82633-2761 | 2018-02-12 |
| 1457890659 | Beyond Home Living, LLC | Assisted Living Facility | 153 Doyle Child Circle, Afton, WY 83110 | 2017-02-21 |
| 1730570128 | Elder Care Inc | Assisted Living Facility | 682 N Main St, Buffalo, WY 82834-1736 | 2015-02-07 |
| 1538581137 | Dubois Assisted Living, Inc | Assisted Living Facility | 5643 Us Highway 26, Dubois, WY 82513-1839 | 2014-01-16 |
| 1962679175 | Sheridan Senior Living, LLC | Assisted Living Facility | 1551 Sugarland Dr, Sheridan, WY 82801 | 2008-05-15 |
| 1750588851 | Legacy Home Assisted Living | Assisted Living Facility | 2391 Muddy String Co. Road 122, Thayne, WY 83127 | 2007-07-02 |
| 1932327517 | Cody Senior Living, LLC | Assisted Living Facility | 2401 Cougar Ave, Cody, WY 82414-8499 | 2007-04-22 |
| 1346360377 | Aspen Wind Assisted Living Community, LLC | Assisted Living Facility | 4010 N College Dr, Cheyenne, WY 82001-1960 | 2007-03-31 |
| 1467585034 | Park Place Assisted Living LLC | Assisted Living Facility | 1930 E 12th St, Casper, WY 82601-4075 | 2007-03-13 |
| Find all providers with the same taxonomy | ||||
| City | JACKSON HOLE |
| Zip Code | 83001 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.