SHANGRI-LA CORPORATION


Address: 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335
Phone: 5035811732

SHANGRI-LA CORPORATION (NPI# 1922352376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922352376
Entity Type Organization
Organization Name SHANGRI-LA CORPORATION
Other Organization Name VIA VERDE
Practice Address 4080 Reed Rd Se Ste 150
Salem
OR 97302-1335
Practice Telephone 5035811732
Practice Fax Number 5033162299
Mailing Telephone 5035811732
Mailing Fax Number 5033162299
Enumeration Date 2012-11-07
Last Update Date 2020-08-10
Authorized Official Name ROBIN LENAY WINKLE (DIRECTOR)
Authorized Official Telephone 5035811732
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness OR Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
OR DMAP PROVIDER # 516845 01

Other Provider/Organization Names

Other Name Type Code
Via Verde Other Name - Individual/Organization

Other Provider IDs and Locations

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
1568617694 Shangri-la Corporation Community Based Residential Treatment Facility, Mental Illness 4080 Reed Rd Se, Suite 150, Salem, OR 97302-1100 2008-11-17
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

Office Location

Street Address 4080 REED RD SE STE 150
City SALEM
State OR
Zip Code 97302-1335

Providers in the same location

NPI Name Taxonomy Address Enumeration
1184826836 Tina Barton Case Manager/Care Coordinator 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2007-06-04
1336756667 Anita Marie Olson Counselor 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2020-09-30
1043844848 Dominic Christepher Lathos Counselor 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2020-03-02
1104450857 Susan Dianne Crabill Counselor 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2020-03-02
1013541762 Rachel Jean Wisner Counselor 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2020-03-02
1194369934 Jennifer Ohren Case Manager/Care Coordinator 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2019-11-05
1881256345 Cadence Noelle Cooper Case Manager/Care Coordinator 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2019-07-05
1528622529 Zackory Henry Robinson Counselor 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2019-04-24
1003373457 Andrea Michele Kahler Counselor 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2019-02-21
1780158535 Stephen Anthony Grillo Counselor 4080 Reed Rd Se Ste 150, Salem, OR 97302-1335 2019-01-15
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

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
1568617694 Shangri-la Corporation Community Based Residential Treatment Facility, Mental Illness 4080 Reed Rd Se, Suite 150, Salem, OR 97302-1100 2008-11-17
1487881959 Marion County Health Department Community Based Residential Treatment Facility, Mental Illness 2435 Greenway Dr Ne, Salem, OR 97301-4535 2009-06-11

Providers in the same taxonomy and state

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
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Competitor

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City SALEM
Zip Code 97302

Improve Information

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Dataset Information

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.

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