SHANGRI-LA CORPORATION (NPI# 1568617694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568617694 |
| Entity Type | Organization |
| Organization Name | SHANGRI-LA CORPORATION |
| Practice Address |
4080 Reed Rd Se Suite 150 Salem OR 97302-1100 |
| Practice Telephone | 5035811732 |
| Practice Fax Number | 5035815638 |
| Mailing Telephone | 5035811732 |
| Mailing Fax Number | 5035815638 |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2020-08-10 |
| Authorized Official Name | ROBIN LENAY WINKLE (DIRECTOR) |
| Authorized Official Telephone | 5035811732 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922352368 | Shangri-la Corporation | Community Based Residential Treatment Facility, Mental Illness | 4472 Del Rio Pl Se, Albany, OR 97322-6233 | 2012-11-07 |
| 1326392770 | Shangri-la Corporation | Community Based Residential Treatment Facility, Mental Illness | 618 Sw 10th Street, Newport, OR 97365-4734 | 2012-11-07 |
| 1366796823 | Shangri-la Corporation | Community Based Residential Treatment Facility, Mental Illness | 2614 Adams Ln Se, Jefferson, OR 97352-9713 | 2012-11-06 |
| 1487908935 | Shangri-la Corporation | Community Based Residential Treatment Facility, Mental Illness | 1206 Old Oak Dr Se, Albany, OR 97322-6655 | 2012-11-06 |
| 1053858993 | Shangri-la Corporation | Community/Behavioral Health | 398 High St, Eugene, OR 97401-2310 | 2017-01-31 |
| 1578000758 | Shangri-la Corporation | Community/Behavioral Health | 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 | 2017-01-25 |
| 1922352376 | Shangri-la Corporation | Community Based Residential Treatment Facility, Mental Illness | 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 | 2012-11-07 |
| Street Address |
4080 REED RD SE SUITE 150 |
| City | SALEM |
| State | OR |
| Zip Code | 97302-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821583147 | Dominique Muguet Schoessler | Case Manager/Care Coordinator | 4080 Reed Rd Se, Salem, OR 97302-1357 | 2018-06-28 |
| 1407302540 | Lisa Dianne Doherty | Registered Nurse | 4080 Reed Rd Se, Salem, OR 97302-1357 | 2016-08-29 |
| 1417296872 | Cynthia A. Shaver | Counselor | 4080 Reed Rd Se, Salem, OR 97302 | 2013-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417221375 | Carrolls Group Care Home Inc | Community Based Residential Treatment Facility, Mental Illness | 293 14th St Se, Salem, OR 97301-4109 | 2012-02-23 |
| 1255605101 | Carrolls Group Care Home Inc | Community Based Residential Treatment Facility, Mental Illness | 1240 Royvonne Ave Se, Salem, OR 97302-1935 | 2012-02-23 |
| 1922352376 | Shangri-la Corporation | Community Based Residential Treatment Facility, Mental Illness | 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 | 2012-11-07 |
| 1487881959 | Marion County Health Department | Community Based Residential Treatment Facility, Mental Illness | 2435 Greenway Dr Ne, Salem, OR 97301-4535 | 2009-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932059 | Rainrock Treatment Center, LLC | Community Based Residential Treatment Facility, Mental Illness | 2990 Brandywine Dr, West Linn, OR 97068-8313 | 2020-11-06 |
| 1770101545 | Northwest Premier LLC | Community Based Residential Treatment Facility, Mental Illness | 560 W Rose St, Lebanon, OR 97355-2624 | 2020-07-08 |
| 1538793856 | Tamekio Russell | Community Based Residential Treatment Facility, Mental Illness | 2072 Sw Sandlewood Pl, Gresham, OR 97080-9752 | 2020-02-25 |
| 1487290342 | Andrew J Thomas | Community Based Residential Treatment Facility, Mental Illness | 2568 Sw 1st Ave, Ontario, OR 97914-1877 | 2019-11-25 |
| 1760046528 | The Sachiko Group, Inc | Community Based Residential Treatment Facility, Mental Illness | 3517 Sw Wonderview Ave, Gresham, OR 97080-8574 | 2019-04-26 |
| 1831660984 | Olthyme LLC | Community Based Residential Treatment Facility, Mental Illness | 30803 Jeppeson Ln, Hermiston, OR 97838-6222 | 2018-12-16 |
| 1679073712 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 622 57th St, Springfield, OR 97478-6821 | 2018-02-15 |
| 1356858369 | Scott Richardson | Community Based Residential Treatment Facility, Mental Illness | 3934 Rio Vista Way, Klamath Falls, OR 97603 | 2017-12-29 |
| 1558877407 | Best Care Treatment Services | Community Based Residential Treatment Facility, Mental Illness | 1470 Nw 4th St, Redmond, OR 97756-1366 | 2017-12-14 |
| 1831640192 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 8336 Highway 62, White City, OR 97530 | 2016-10-20 |
| Find all providers with the same taxonomy | ||||
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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.