AMAZING GRACE CARE HOMES, INCESIDENT (NPI# 1376081810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376081810 |
Entity Type | Organization |
Organization Name | AMAZING GRACE CARE HOMES, INCESIDENT |
Practice Address |
1205 Barnes Ave Se Salem OR 97306-1539 |
Mailing Address |
6995 Sw Nyberg St Suite X201 Tualatin OR 97062-7455 |
Practice Telephone | 5039998159 |
Mailing Telephone | 5039998159 |
Enumeration Date | 2017-02-04 |
Last Update Date | 2017-02-04 |
Authorized Official Name | SHERRI M JEMISON (PRESIDENT) |
Authorized Official Telephone | 5039998159 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
511482 | OR | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | MARION COUNTY MENTAL HEALTH AFC PROVIDER | 500500049 | 01 |
Street Address |
1205 BARNES AVE SE |
City | SALEM |
State | OR |
Zip Code | 97306-1539 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134609050 | Andrea P Merryman | Dental Assistant | 5135 Skyline Rd South, Salem, OR 97306 | 2018-08-20 |
1215470315 | Anthony Quoc Ngo | Nurse Practitioner | 5050 Skyline Village Loop, Salem, OR 97306 | 2016-11-22 |
1134521305 | Wendy Poling | Occupational Therapy Assistant | 1966 Madras St Se Apt 1082, Salem, OR 97306 | 2014-09-19 |
1659601045 | Monarch Medical Group LLC | Clinic/Center | 5686 Commercial St Se, Suite 100, Salem, OR 97306 | 2010-01-06 |
1316188006 | Judith A Mitchell | Physician Assistant | 4999 Skyline Rd. S., Salem, OR 97306 | 2009-03-10 |
1164685574 | Leon Chira | Pharmacist | 2431 Concomly Rd S, Salem, OR 97306 | 2008-07-07 |
1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
1326257486 | Robert Allen Long | Physical Therapist | 6250 Commercial St N.e., Salem, OR 97306 | 2007-05-22 |
1922137504 | Charlene Garbutt | Dental Assistant | 5135 Skyline Rd. S., Salem, OR 97306 | 2007-03-02 |
1417085747 | Michelle West | Dental Assistant | 5135 Skyline R S, Salem, OR 97306 | 2007-02-28 |
Find all providers in zip 97306 |
Taxonomy Code | 3104A0630X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
Specialization | Assisted Living, Behavioral Disturbances |
A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881295921 | Devona Lynn Shepard | Assisted Living Facility | 1030 Sw 8th Ave, Ontario, OR 97914-3316 | 2020-11-05 |
1619592193 | Concepts In Community Living, Inc. | Assisted Living Facility | 1337 Sw Washington St, Portland, OR 97205-2328 | 2020-06-10 |
1598313199 | Bernadette Frances Smith | Assisted Living Facility | 92158 Cape Arago Hwy, Coos Bay, OR 97420-8743 | 2019-08-28 |
1477090504 | Michelle Hasson | Assisted Living Facility | 4548 Sw 191st Ave, Aloha, OR 97078-2425 | 2017-01-26 |
1508215252 | Meadowland Adult Foster Home LLC | Assisted Living Facility | 706 Meadow Ave, Tillamook, OR 97141-2844 | 2016-06-03 |
1447636071 | Community Services, Inc. | Assisted Living Facility | 14215 Nw Science Park Dr, Portland, OR 97229-5416 | 2015-08-05 |
1346589728 | Nursefinders | Assisted Living Facility | 5510 Nw 146th Ave, Portland, OR 97229-9263 | 2013-02-05 |
1437317229 | Ocean Park | Assisted Living Facility | 984 Parkview Dr, Brookings, OR 97415-9116 | 2008-05-28 |
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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.