CORDOVA ESTATES ASSISTED LIVING AND MEMORY CARE (CORDOVA SENIOR LIVING, LLC) NPI 1013138122

Assisted Living Facility in Cordova, TN

NPI 1013138122 Organization Assisted Living Facility

About CORDOVA ESTATES ASSISTED LIVING AND MEMORY CARE (CORDOVA SENIOR LIVING, LLC)

Cordova Estates Assisted Living And Memory Care (cordova Senior Living, Llc) is a provider established in Cordova, Tennessee specializing in assisted living facility. The NPI number of Cordova Estates Assisted Living And Memory Care (cordova Senior Living, Llc) is 1013138122 and was assigned on May 2007. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Cordova Estates Assisted Living And Memory Care. The authorized official of this NPI record is Jon Harder (Manager)

NPI

1013138122

Provider NameCORDOVA ESTATES ASSISTED LIVING AND MEMORY CARE (CORDOVA SENIOR LIVING, LLC)
Provider Location Address1535 APPLING CARE LANE CORDOVA, TN 38018
Provider Mailing Address3723 FAIRVIEW INDUSTRIAL DR SE SALEM, OR 97302
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameCORDOVA ESTATES ASSISTED LIVING AND MEMORY CARE
Other Name TypeDoing Business As (3)
Enumeration Date05-02-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code310400000X
ClassificationAssisted Living Facility
TypeNursing & Custodial Care Facilities
Taxonomy DescriptionA 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.

Business Address

CORDOVA ESTATES ASSISTED LIVING AND MEMORY CARE
1535 APPLING CARE LANE
CORDOVA, TN
ZIP 38018
Phone: (901) 377-7500

Get Directions


Mailing Address

CORDOVA ESTATES ASSISTED LIVING AND MEMORY CARE
3723 FAIRVIEW INDUSTRIAL DR SE
SALEM, OR
ZIP 97302
Phone: (503) 485-4600



Authorized Official

Authorized Official Name JON HARDER
Authorized Official TitleMANAGER
Authorized Official Phone(503) 485-4600

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.