FM CEDAR VILLAGE, LLC (NPI# 1720604499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720604499 |
Entity Type | Organization |
Organization Name | FM CEDAR VILLAGE, LLC |
Practice Address |
4452 Lancaster Dr Ne Salem OR 97305-1697 |
Mailing Address |
7420 Sw Bridgeport Rd Ste 105 Portland OR 97224-7790 |
Practice Telephone | 5033909600 |
Practice Fax Number | 5033909152 |
Mailing Telephone | 5035974906 |
Mailing Fax Number | 5034431919 |
Enumeration Date | 2020-06-18 |
Last Update Date | 2020-06-18 |
Authorized Official Name | GREGORY A RODERICK (MEMBER) |
Authorized Official Telephone | 5034431818 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 526907 | 05 | |
OR | 526908 | 05 |
Other Name | Type Code |
---|---|
Cedar Village Assisted Living & Memory Care | Doing Business As Name - Organization |
Street Address |
4452 LANCASTER DR NE |
City | SALEM |
State | OR |
Zip Code | 97305-1697 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821639147 | Christine Ann Featherstone | Social Worker | Chemawa Indian Health Center, 3750 Chemawa Road, Salem, OR 97305 | 2019-10-08 |
1962996553 | Erin Ann Wakefield | Non-emergency Medical Transport (VAN) | 2425 Fisher Rd Ne, Salem, OR 97305 | 2018-06-18 |
1770002271 | Traci L Lee | Case Manager/Care Coordinator | 3876 Beverly Ave Bldg G, Salem, OR 97305 | 2017-09-15 |
1952825762 | Matthew Paul Martin | Dentist | 2737 Lancaster Dr Ne Ste 150, Salem, OR 97305 | 2017-08-02 |
1043750367 | Sherri King | Physical Therapy Assistant | 4696 Reimann St Ne, Salem, OR 97305 | 2017-03-06 |
1760861314 | Amara Lenore Peterson | Counselor | 4347 Sunnyview Rd Ne, Salem, OR 97305 | 2015-05-28 |
1720467954 | Heather Rose | Community Health Worker | 4347 Sunnyview Road Ne, Salem, OR 97305 | 2015-05-20 |
1588057004 | Carmen Heidecke | Counselor | 4347 Sunnyview Rd. Ne, Salem, OR 97305 | 2015-03-08 |
1629476825 | Bryan James Greenaway | Audiologist | 3857 Wolverine St Ne Ste C-16, Salem, OR 97305 | 2014-12-21 |
1710300322 | Christopher Ryan | Counselor | 4385 Sunnyview Road Ne, Salem, OR 97305 | 2014-02-03 |
Find all providers in zip 97305 |
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 |
---|---|---|---|---|
1689290231 | Fm Redwood Heights, LLC | Assisted Living Facility | 4050 12th St Cutoff Se, Salem, OR 97302-1775 | 2020-06-19 |
1154946457 | Willson House | Assisted Living Facility | 1625 Center St Ne, Salem, OR 97301-4268 | 2020-06-11 |
1255964573 | Cottages At Salem, Inc. | Assisted Living Facility | 339 S Hotze Rd, Salem, IL 62881-6858 | 2020-02-14 |
1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
1902040769 | Regency At Salem, LLC | Assisted Living Facility | 4710 Sunnyside Rd Se, Salem, OR 97302-3504 | 2009-04-23 |
1013159995 | Elder Assisted Living LLC | Assisted Living Facility | 1015 S 550 W, Salem, UT 84653 | 2009-03-24 |
1750522389 | Brookdale Senior Living Communities Inc | Assisted Living Facility | 1916 S Lincoln Ave, Salem, OH 44460-4385 | 2009-03-11 |
1265694111 | Meadow Creek Limited Partnership | Assisted Living Facility | 3988 12th St Se, Salem, OR 97302 | 2008-07-01 |
1730347097 | Salem Elderly Living LLC | Assisted Living Facility | 600 S Hill St, Salem, SD 57058-8707 | 2008-05-22 |
1245408053 | The Manor At Salem Woods, L.p. | Assisted Living Facility | 441 S. Hotze Rd., Salem, IL 62881 | 2008-02-14 |
Find all providers in SALEM |
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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.