PACIFIC LIVING CENTERS SOUTH LLC NPI 1700530987

NPI Information

  • NPI: 1700530987
  • Provider Name: PACIFIC LIVING CENTERS SOUTH, LLC
  • Classification: Assisted Living Facility - 3104A0625X
  • Specialization: Assisted Living, Mental Illness
  • Entity Type: Organization
  • Address: 1635 KELLENBECK AVE
    GRANTS PASS, OR
    ZIP 97527
  • Phone: (541) 474-6493

Map and Directions

Get Directions

NPI Details

PACIFIC LIVING CENTERS SOUTH, LLC is an assisted living and mental illness assisted living facility in Grants Pass, OR. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. PACIFIC LIVING CENTERS SOUTH, LLC NPI is 1700530987. The provider is registered as an organization entity type.

The provider's business location address is:

1635 KELLENBECK AVE
GRANTS PASS, OR
ZIP 97527-247
Phone: (541) 474-6493

The provider's authorized official is Carl Mason .
The authorized official title is Coo and has the following contact phone number (503) 826-5190.

The enumeration date for this NPI number is 2/7/2022 and was last updated on 2/7/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13104A0625XAssisted Living FacilityAssisted Living, Mental IllnessYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17715251304OTHEROREGONDHS APD
23246694719OTHEROREGONDHS APD
35482307390OTHEROREGONDHS APD
48850499803OTHEROREGONDHS APD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI