85
FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY ADMINISTRATOR, PHONE COUNTY, LOCAL UNITS MEDICAID PROVIDER 50M098 Aaren Brooke Place 995 N Oregon St Malheur Ontario MSO Capacity: 14 Administrator: Wendy Osborne Facility Phone: (541) 881-1188 Facility Fax: (541) 881-9082 Owner: Ashley Manor, L.L.C. County Orig Lic. Date: 1980-01-01 Ontario, OR 97914 Renewal Date : 2018-04-30 0 Units: 14 Management: Ashley Manor, L.L.C. Yes Email: [email protected] Other Services: 70M001 Adams House Assisted Living 121 Cordelia Drive Douglas Roseburg Capacity: 40 Administrator: Susan Lebengood Facility Phone: (541) 863-4444 Facility Fax: (541) 863-7978 Owner: Assisted Living Facilities, Inc. County Orig Lic. Date: 1996-04-01 Myrtle Creek, OR 97457 Renewal Date : 2018-03-31 0 Units: 34 Management: Concepts in Community Living, Inc. Yes Email: [email protected] Other Services: 50R378 Adara Oaks Manor 931 NE Linden Avenue Multnomah E Mult ADS Capacity: 60 Administrator: Spencer Ross Facility Phone: (503) 912-3211 Facility Fax: (503) 512-7477 Owner: Adara Oaks Manor, LLC County Orig Lic. Date: 2011-06-30 Gresham, OR 97030 Renewal Date : 2016-11-30 0 Units: 42 Management: Adara Oaks Manor, LLC Yes Email: [email protected] Other Services: 50R417 Advocate Care 13033 South East Holgate Blvd Multnomah Multnomah Capacity: 34 Administrator: Leah Lichens Facility Phone: (971) 271-8547 Facility Fax: (971) 271-8602 Owner: Advocate Care, LLC County Orig Lic. Date: 2015-04-27 Portland, OR 97236 Renewal Date : 2017-04-30 0 Units: 34 Management: Advocate Care, LLC Yes Email: [email protected] Other Services: 70M002 Alderwood Assisted Living 131 Alder St Jackson Medford Capacity: 64 Administrator: Sandra Monday Facility Phone: (541) 664-3757 Facility Fax: (541) 664-8527 Owner: Alderwood Assisted Living, LLC County Orig Lic. Date: 1995-08-01 Central Point, OR 97502 Renewal Date : 2018-02-28 0 Units: 60 Management: AIM Senior Management, LLC Yes Email: [email protected] Other Services: 50R315 All Comfort Residential Care 9347 SW 35th St. Multnomah WCDAVS Capacity: 16 Administrator: Breanna Mattson Facility Phone: (503) 977-0606 Facility Fax: (503) 977-1011 Owner: Peaks and Valleys, LLC County Orig Lic. Date: 2003-04-24 Portland, OR 97219 Renewal Date : 2016-08-31 0 Units: 16 Management: Peaks and Valleys, LLC Yes Email: [email protected] Other Services: Tuesday, July 05, 2016 Page 1 of 85

€¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

  • Upload
    others

  • View
    2

  • Download
    0

Embed Size (px)

Citation preview

Page 1: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50M098

Aaren Brooke Place

995 N Oregon St

Malheur

Ontario MSO

Capacity: 14

Administrator: Wendy Osborne

Facility Phone: (541) 881-1188

Facility Fax: (541) 881-9082

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 1980-01-01 Ontario, OR 97914

Renewal Date :2018-04-30 0

Units: 14

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

70M001

Adams House Assisted Living

121 Cordelia Drive

Douglas

Roseburg

Capacity: 40

Administrator: Susan Lebengood

Facility Phone: (541) 863-4444

Facility Fax: (541) 863-7978

Owner: Assisted Living Facilities, Inc.County

Orig Lic. Date: 1996-04-01 Myrtle Creek, OR 97457

Renewal Date :2018-03-31 0

Units: 34

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

50R378

Adara Oaks Manor

931 NE Linden Avenue

Multnomah

E Mult ADS

Capacity: 60

Administrator: Spencer Ross

Facility Phone: (503) 912-3211

Facility Fax: (503) 512-7477

Owner: Adara Oaks Manor, LLCCounty

Orig Lic. Date: 2011-06-30 Gresham, OR 97030

Renewal Date :2016-11-30 0

Units: 42

Management: Adara Oaks Manor, LLC

Yes

Email: [email protected]

Other Services:

50R417

Advocate Care

13033 South East Holgate Blvd

Multnomah

Multnomah

Capacity: 34

Administrator: Leah Lichens

Facility Phone: (971) 271-8547

Facility Fax: (971) 271-8602

Owner: Advocate Care, LLCCounty

Orig Lic. Date: 2015-04-27 Portland, OR 97236

Renewal Date :2017-04-30 0

Units: 34

Management: Advocate Care, LLC

Yes

Email: [email protected]

Other Services:

70M002

Alderwood Assisted Living

131 Alder St

Jackson

Medford

Capacity: 64

Administrator: Sandra Monday

Facility Phone: (541) 664-3757

Facility Fax: (541) 664-8527

Owner: Alderwood Assisted Living, LLCCounty

Orig Lic. Date: 1995-08-01 Central Point, OR 97502

Renewal Date :2018-02-28 0

Units: 60

Management: AIM Senior Management, LLC

Yes

Email: [email protected]

Other Services:

50R315

All Comfort Residential Care

9347 SW 35th St.

Multnomah

WCDAVS

Capacity: 16

Administrator: Breanna Mattson

Facility Phone: (503) 977-0606

Facility Fax: (503) 977-1011

Owner: Peaks and Valleys, LLCCounty

Orig Lic. Date: 2003-04-24 Portland, OR 97219

Renewal Date :2016-08-31 0

Units: 16

Management: Peaks and Valleys, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 1 of 85

Page 2: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M003

Alpine House Assisted Living

204 N Park St

Wallowa

Enterprise MSO

Capacity: 36

Administrator: Margo Peppers

Facility Phone: (541) 432-7402

Facility Fax: (541) 432-3301

Owner: Joseph ALF, Inc.County

Orig Lic. Date: 1995-04-01 Joseph, OR 97846

Renewal Date :2017-04-30 0

Units: 30

Management: Joseph ALF, Inc.

Yes

Email: [email protected]

Other Services:

70A287

Amber Assisted Living, The

365 SW Bel Air Drive- PO Box 308

Columbia

St. Helens MSO

Capacity: 40

Administrator: Darla Sharer

Facility Phone: (503) 728-2744

Facility Fax: (503) 728-4038

Owner: Amber Investors, LLCCounty

Orig Lic. Date: 2003-03-21 Clatskanie, OR 97016

Renewal Date :2016-08-31 0

Units: 32

Management: Ageia Health Services, LLC

Yes

Email: [email protected]

Other Services:

50R339

Angeline Senior Living

501 3rd St.

Union

La Grande MSO

Capacity: 15

Administrator: Elizabeth Neaves

Facility Phone: (541) 975-2418

Facility Fax: (541) 962-0542

Owner: Angeline Senior Living, LLCCounty

Orig Lic. Date: 1999-10-04 La Grande, OR 97850

Renewal Date :2017-08-31 0

Units: 11

Management: Angeline Senior Living, LLC

Yes

Email: [email protected]

Other Services:

50R371

Applegate House of Grants Pass

1635 Kellenbeck Avenue

Josephine

Grants Pass DSO

Capacity: 15

Administrator: Stacey Smith

Facility Phone: (541) 474-6493

Facility Fax: (541) 474-6742

Owner: Pacific Living Centers, Inc.County

Orig Lic. Date: 2011-01-06 Grants Pass, OR 97528

Renewal Date :2017-01-31 0

Units: 15

Management: Pacific Living Centers, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 15

70M022

Applegate Place

1465 East Central

Douglas

Roseburg

Capacity: 36

Administrator: Robert Moore

Facility Phone: (541) 459-6300

Facility Fax: (541) 459-6302

Owner: Sutherlin ALF, Inc.County

Orig Lic. Date: 1997-02-01 Sutherlin, OR 97479

Renewal Date :2017-01-31 0

Units: 30

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

50R414

Arbor at Avamere Court, The

450 Claggett Court N

Marion

Salem NWSDS

Capacity: 48

Administrator: Shirley Confer

Facility Phone: (503) 856-7440

Facility Fax: (503) 390-1271

Owner: Keizer River Operations, LLCCounty

Orig Lic. Date: 2014-10-20 Keizer, OR 97303

Renewal Date :2016-10-31 0

Units: 48

Management: Keizer River Operations, LLC

Non Medicaid

Email: [email protected]

Other Services: MC, ACU 48

Tuesday, July 05, 2016 Page 2 of 85

Page 3: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R328

Arbor House of Grants Pass

820 Gold Court

Josephine

Grants Pass AAA

Capacity: 15

Administrator: Athena Cromwell

Facility Phone: (541) 474-7887

Facility Fax: (541) 474-7005

Owner: Pacific Living Centers, Inc.County

Orig Lic. Date: 2004-08-20 Grants Pass, OR 97527

Renewal Date :2016-08-31 0

Units: 11

Management: Pacific Living Centers, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 15

50R367

Arbor Oaks Terrace Memory Care

317 Werth Blvd.

Yamhill

McMinnville NWSDS

Capacity: 48

Administrator: Tia Woodall

Facility Phone: (503) 538-2288

Facility Fax: (503) 538-2226

Owner: Newberg Memory Associates, LLCCounty

Orig Lic. Date: 2010-04-14 Newberg, OR 97132

Renewal Date :2018-04-30 0

Units: 48

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 48

5MA166

Ashley Manor - Alameda

1310 SW 12th Ave

Malheur

Ontario MSO

Capacity: 14

Administrator: Melissa Grimes

Facility Phone: (541) 889-6280

Facility Fax: (541) 889-6302

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 1998-04-24 Ontario, OR 97914

Renewal Date :2018-04-30 0

Units: 14

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

50R295

Ashley Manor - Anique

525 Anique Ln

Josephine

Grants Pass MSO

Capacity: 15

Administrator: Tamra Morey

Facility Phone: (541) 474-4376

Facility Fax: (541) 474-4598

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2002-03-18 Grants Pass, OR 97526

Renewal Date :2017-05-31 0

Units: 15

Management: Ashley Manor, L.L.C.

Yes

Email: anique@ashleycares .com

Other Services:

50R274

Ashley Manor - Arrowhead

3853 Arrowhead Dr.

Jackson

Medford AAA

Capacity: 11

Administrator: Judith Annin

Facility Phone: (541) 282-0467

Facility Fax: (541) 770-6545

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2001-04-16 Medford, OR 97504

Renewal Date :2017-05-31 0

Units: 11

Management: Ashley Manor, L.L.C.

Non Medicaid

Email: [email protected]

Other Services:

50R288

Ashley Manor - Athens

1514 Athens Ave.

Umatilla

Pendleton MSO

Capacity: 15

Administrator: Christina Allbritton

Facility Phone: (541) 278-6776

Facility Fax: (541) 278-6776

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2001-10-01 Pendleton, OR 97801

Renewal Date :2017-04-30 0

Units: 11

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 3 of 85

Page 4: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

5MA246

Ashley Manor - Brookhurst

2146 Brookhurst

Jackson

Medford AAA

Capacity: 14

Administrator: Ashley Morgan

Facility Phone: (541) 618-9050

Facility Fax: (541) 773-7438

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2000-05-01 Medford, OR 97504

Renewal Date :2017-05-31 0

Units: 14

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

50R281

Ashley Manor - Conners

2853 NE Conners Ave.

Deschutes

Bend MSO

Capacity: 15

Administrator: Antonio Cornelio

Facility Phone: (541) 383-4400

Facility Fax: (541) 383-4984

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2001-07-26 Bend, OR 97701

Renewal Date :2017-04-30 0

Units: 11

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

5MA255

Ashley Manor - Heidi Lane

2144 NW Heidi Lane

Josephine

Grants Pass MSO

Capacity: 15

Administrator: Teresa Heard

Facility Phone: (541) 955-1816

Facility Fax: (541) 955-0774

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2000-09-25 Grants Pass, OR 97526

Renewal Date :2017-05-31 0

Units: 15

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

50R306

Ashley Manor - Homedale

44 North Homedale Rd.

Klamath

Klamath Falls

Capacity: 15

Administrator: Billi Hughes

Facility Phone: (541) 850-3770

Facility Fax: (541) 273-1220

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2002-11-27 Klamath Falls, OR 97601

Renewal Date :2017-05-31 0

Units: 15

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

50M204

Ashley Manor - Lund Lane

1040 Lund Lane

Baker

Baker City MSO

Capacity: 9

Administrator: Debbie Howerton

Facility Phone: (541) 524-9880

Facility Fax: (541) 523-3091

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 1999-08-13 Baker City, OR 97814

Renewal Date :2017-08-31 0

Units: 9

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

5MA238

Ashley Manor - Meadow Lakes

228 SW Meadow Lakes Drive

Crook

Prineville MSO

Capacity: 15

Administrator: Trisha Gilbert

Facility Phone: (541) 447-5816

Facility Fax: (541) 447-1546

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2000-03-03 Prineville, OR 97754

Renewal Date :2017-04-30 0

Units: 11

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 4 of 85

Page 5: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

5MA241

Ashley Manor - Oak

572 NE Oak Street

Jefferson

Madras MSO

Capacity: 15

Administrator: Taylor Lanning

Facility Phone: (541) 475-7635

Facility Fax: (541) 475-3981

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2000-03-29 Madras, OR 97741

Renewal Date :2017-04-30 0

Units: 15

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

50M267

Ashley Manor - Pacific Heights

1995 8th St.

Hood River

The Dalles MSO

Capacity: 15

Administrator: Sarah Johnson

Facility Phone: (541) 387-4514

Facility Fax: (541) 387-0249

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2001-03-08 Hood River, OR 97031

Renewal Date :2017-04-30 0

Units: 15

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

50M265

Ashley Manor - Rimrock

1600 SW Rimrock Way

Deschutes

Bend MSO

Capacity: 15

Administrator: Mindy Forrester

Facility Phone: (541) 504-8855

Facility Fax: (541) 504-8510

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 2001-02-20 Redmond, OR 97756

Renewal Date :2017-04-30 0

Units: 15

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

5MA233

Ashley Manor - Roseburg

427 SE Ramp St.

Douglas

Roseburg AAA

Capacity: 30

Administrator: Cady Hale

Facility Phone: (541) 464-0961

Facility Fax: (541) 672-2713

Owner: Ashley Manor LLCCounty

Orig Lic. Date: 2000-02-07 Roseburg, OR 97470

Renewal Date :2017-11-30 0

Units: 30

Management: Ashley Manor LLC

Yes

Email: [email protected]

Other Services:

5MA003

Ashley Manor - Sage

1355 SW Sage

Umatilla

Pendleton MSO

Capacity: 40

Administrator: Kimberly Cates

Facility Phone: (541) 567-1991

Facility Fax: (541) 567-3252

Owner: Ashley Manor, LLCCounty

Orig Lic. Date: 1992-12-01 Hermiston, OR 97838

Renewal Date :2017-02-28 0

Units: 30

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

50M220

Ashley Manor - Shasta

475 S Shasta Pl. Longview Div.

Harney

Burns MSO

Capacity: 15

Administrator: Markie Sykes

Facility Phone: (541) 573-3029

Facility Fax: (541) 573-3049

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 1999-03-24 Burns, OR 97720

Renewal Date :2017-03-31 0

Units: 15

Management: Ashley Manor, L.L.C.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 5 of 85

Page 6: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

5MA206

Ashley Manor - Well Springs

2110 SW 2nd Avenue

Malheur

Ontario MSO

Capacity: 10

Administrator: Lindsay Wilson

Facility Phone: (541) 881-9136

Facility Fax: (541) 881-9165

Owner: Ashley Manor, L.L.C.County

Orig Lic. Date: 1999-08-13 Ontario, OR 97914

Renewal Date :2017-08-31 0

Units: 10

Management: Ashley Manor, L.L.C.

Non Medicaid

Email: [email protected]

Other Services:

5MA221

Aspen Ridge Memory Care

1025 NE Purcell Blvd

Deschutes

Bend MSO

Capacity: 42

Administrator: Kim Luis

Facility Phone: (541) 385-8500

Facility Fax: (541) 312-6674

Owner: FM Aspen MC, LLCCounty

Orig Lic. Date: 1999-05-26 Bend, OR 97701

Renewal Date :2017-01-31 0

Units: 42

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 42

70M217

Aspen Ridge Retirement Community

1010 NE Purcell

Deschutes

Bend MSO

Capacity: 95

Administrator: Bryan Carnahan

Facility Phone: (541) 385-8500

Facility Fax: (541) 330-6687

Owner: FM Aspen Ret, LLCCounty

Orig Lic. Date: 1999-09-13 Bend, OR 97701

Renewal Date :2017-01-31 0

Units: 65

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

70M005

Aspens (The)

210 Roe Davis Ave

Harney

Burns MSO

Capacity: 48

Administrator: Ryan Dupuy

Facility Phone: (541) 573-2222

Facility Fax: (541) 573-2224

Owner: Harney Pioneer Homes, IncCounty

Orig Lic. Date: 1996-03-07 Hines, OR 97738

Renewal Date :2018-02-28 0

Units: 40

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

70A278

Assumption Village

9121 N. Burr Avenue

Multnomah

NE Portland ASO/DSO

Capacity: 84

Administrator: E'lan Calise

Facility Phone: (503) 283-5644

Facility Fax: (503) 283-5692

Owner: Assumption Village LLCCounty

Orig Lic. Date: 2002-05-29 Portland, OR 97203

Renewal Date :2016-05-31 0

Units: 77

Management: S.A.G.E.

Yes

Email: [email protected]

Other Services:

70M007

Astor Place

999 Klaskanine Ave

Clatsop

Warrenton NWSDS

Capacity: 34

Administrator: Larry Reed

Facility Phone: (503) 325-6970

Facility Fax: (503) 325-9555

Owner: ASTOR AID OPCO, LLCCounty

Orig Lic. Date: 1996-08-20 Astoria, OR 97103

Renewal Date :2017-07-31 0

Units: 28

Management: ASTOR AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 6 of 85

Page 7: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R327

Atrium at Flagstone, The

3325 Columbia View Dr.

Wasco

The Dalles

Capacity: 33

Administrator: Karen Wilson

Facility Phone: (541) 298-5656

Facility Fax: (541) 298-1535

Owner: Flagstone Operations, LLC.County

Orig Lic. Date: 2004-08-13 The Dalles, OR 97058

Renewal Date :2016-10-31 0

Units: 17

Management: Milestone Retirement Communities, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 33

5MA162

Atrium at McLoughlin Place, The

1153 Molalla Ave

Clackamas

Clackamas AAA

Capacity: 50

Administrator: Amy Clapp

Facility Phone: (503) 655-3337

Facility Fax: (503) 656-6939

Owner: McLoughlin Place Operations, LLCCounty

Orig Lic. Date: 1997-03-01 Oregon City, OR 97045

Renewal Date :2016-10-31 0

Units: 25

Management: Milestone Retirement Communities, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 50

50M006

Autumn Garden Home RCF, Inc.

6215 SE Hazel Ave.

Clackamas

Milwaukie SPD

Capacity: 10

Administrator: Silviu Bumb

Facility Phone: (503) 771-5305

Facility Fax: (503) 771-5305

Owner: Autumn Garden Home RCF, LLCCounty

Orig Lic. Date: 1980-01-01 Portland, OR 97206

Renewal Date :2018-03-31 0

Units: 10

Management: Autumn Garden Home RCF, LLC

Yes

Email: [email protected]

Other Services:

50R343

Autumn House of Grants Pass

PO Bx 1419 2268 Williams Hwy

Josephine

Grants Pass SDS

Capacity: 15

Administrator: Tanelia Valenzuela

Facility Phone: (541) 474-6399

Facility Fax: (541) 474-6736

Owner: Pacific Living Centers, Inc.County

Orig Lic. Date: 2006-09-22 Grants Pass, OR 97528

Renewal Date :2016-09-30 0

Units: 13

Management: Pacific Living Centers, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 15

50R320

Avamere at Bethany

16360 NW Avamere Court

Washington

WCDAVS

Capacity: 26

Administrator: Angela Newsom

Facility Phone: (503) 690-2402

Facility Fax: (503) 690-2134

Owner: Avamere Bethany Operations, LLCCounty

Orig Lic. Date: 2003-08-29 Portland, OR 97229

Renewal Date :2017-09-30 0

Units: 13

Management: Avamere Bethany Operations, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 26

70A291

Avamere at Bethany Assisted Living Facility

16360 NW Avamere Court

Washington

Hillsboro

Capacity: 90

Administrator: Alex McVay

Facility Phone: (503) 690-2402

Facility Fax: (503) 690-2134

Owner: Avamere Bethany Operations, LLCCounty

Orig Lic. Date: 2003-08-08 Portland, OR 97229

Renewal Date :2017-08-31 0

Units: 71

Management: Avamere-Bethany Operations, LLC

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 7 of 85

Page 8: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

5MA261

Avamere at Hillsboro

2000 SE 30th Avenue

Washington

WCDAVS

Capacity: 24

Administrator: Tim Minks

Facility Phone: (503) 693-9944

Facility Fax: (503) 640-6654

Owner: Avamere-Hillsboro Operations, LLCCounty

Orig Lic. Date: 2000-11-06 Hillsboro, OR 97123

Renewal Date :2016-11-30 0

Units: 12

Management: Avamere-Hillsboro Operations, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 24

70M245

Avamere at Hillsboro Assisted Living Facility

2000 SE 30th Ave.

Washington

WCDAVS

Capacity: 75

Administrator: Mark Bruhns

Facility Phone: (503) 693-9944

Facility Fax: (503) 640-6654

Owner: Avamere Hillsboro Operations, LLCCounty

Orig Lic. Date: 2000-09-26 Hillsboro, OR 97123

Renewal Date :2016-09-30 0

Units: 65

Management: Avamere-Hillsboro Operations, LLC

Yes

Email: [email protected]

Other Services:

5MA259

Avamere at Newberg

730 Foothills Dr.

Yamhill

McMinnville NWSDS

Capacity: 22

Administrator: JK Soderquist

Facility Phone: (503) 554-0767

Facility Fax: (503) 554-0436

Owner: Genesis Newberg Operations Company, LLCCounty

Orig Lic. Date: 2000-10-02 Newberg, OR 97132

Renewal Date :2016-10-31 0

Units: 22

Management: Genesis Newberg Operations Company, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 22

5MA249

Avamere at Sandy

17727 SE Langensand Rd

Clackamas

Estacada SPD

Capacity: 24

Administrator: Cathi Davenport

Facility Phone: (503) 668-4199

Facility Fax: (503) 668-7758

Owner: Avamere-Sandy Operations, LLCCounty

Orig Lic. Date: 2000-07-05 Sandy, OR 97055

Renewal Date :2018-07-31 0

Units: 20

Management: Avamere Sandy Operations, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 24

70M231

Avamere at Sandy Assisted Living Facility

17727 SE Langensand

Clackamas

Estacada SPD

Capacity: 65

Administrator: Alex Vinokurov

Facility Phone: (503) 668-4199

Facility Fax: (503) 668-7758

Owner: Avamere-Sandy Operations, LLCCounty

Orig Lic. Date: 2000-03-31 Sandy, OR 97055

Renewal Date :2018-03-31 0

Units: 55

Management: Avamere-Sandy Operations, LLC

Yes

Email: [email protected]

Other Services:

70A275

Avamere at Seaside

2500 S. Roosevelt Dr.

Clatsop

Warrenton NWSDS

Capacity: 64

Administrator: Kerry Clark

Facility Phone: (503) 738-0900

Facility Fax: (503) 738-0903

Owner: Necanicum Operations, LLCCounty

Orig Lic. Date: 2002-04-25 Seaside, OR 97138

Renewal Date :2017-04-30 0

Units: 41

Management: Necanicum Operations, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 8 of 85

Page 9: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R296

Avamere at Seaside Residential Care Facility

2500 S. Roosevelt Dr.

Clatsop

Warrenton NWSDS

Capacity: 40

Administrator: Jessica Riches

Facility Phone: (503) 738-0900

Facility Fax: (503) 738-0903

Owner: Necanicum Operations, LLCCounty

Orig Lic. Date: 2002-04-25 Seaside, OR 97138

Renewal Date :2017-04-30 0

Units: 27

Management: Necanicum Operations, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 40

5MA245

Avamere at Sherwood

16500 SW Century Drive

Washington

WCDAVS

Capacity: 24

Administrator: Shirley Confer

Facility Phone: (503) 625-7333

Facility Fax: (503) 625-6565

Owner: Avamere Sherwood Operations, LLCCounty

Orig Lic. Date: 2000-04-25 Sherwood, OR 97140

Renewal Date :2018-02-28 0

Units: 12

Management: Avamere-Sherwood Operations, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 24

70M227

Avamere at Sherwood Assisted Living Facility

16500 SW Century Dr.

Washington

WCDAVS

Capacity: 65

Administrator: Patty Odenborg

Facility Phone: (503) 625-7333

Facility Fax: (503) 625-6565

Owner: Avamere Sherwood Operations, LLCCounty

Orig Lic. Date: 2000-01-28 Sherwood, OR 97140

Renewal Date :2018-02-28 0

Units: 55

Management: Avamere-Sherwood Operations, LLC

Yes

Email: [email protected]

Other Services:

50R275

Avamere at St. Helens

2400 Gable Rd.

Columbia

St. Helens MSO

Capacity: 28

Administrator: Michelle Endicott

Facility Phone: (503) 366-8070

Facility Fax: (503) 366-8088

Owner: Avamere - St. Helens Operations, LLCCounty

Orig Lic. Date: 2001-04-09 St. Helens, OR 97051

Renewal Date :2017-04-30 0

Units:

Management: Avamere-St. Helens Operations, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 28

50A235

Avamere at Waterford

760 Spring Street

Jackson

Medford

Capacity: 20

Administrator: Christy Kruse

Facility Phone: (541) 773-7718

Facility Fax: (541) 773-7719

Owner: Waterford Operations, LLCCounty

Orig Lic. Date: 2000-02-14 Medford, OR 97504

Renewal Date :2016-10-31 0

Units: 15

Management: Waterford Operations, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 20

70M218

Avamere at Waterford Assisted Living Facility

760 Spring Street

Jackson

Medford SSO

Capacity: 85

Administrator: Christy Kruse

Facility Phone: (541) 773-7718

Facility Fax: (541) 857-5139

Owner: Waterford Operations, LLCCounty

Orig Lic. Date: 1999-06-23 Medford, OR 97504

Renewal Date :2016-10-31 0

Units: 68

Management: Waterford Operations, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 9 of 85

Page 10: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R068

Avamere Court at Keizer RCF

5210 River Road N

Marion

Salem NWSDS

Capacity: 63

Administrator: Rebecca Tlusty

Facility Phone: (503) 393-3624

Facility Fax: (503) 393-0108

Owner: Keizer Campus Operations, LLCCounty

Orig Lic. Date: 1992-07-31 Keizer, OR 97307

Renewal Date :2017-03-31 0

Units: 53

Management: Keizer Campus Operations, LLC

Yes

Email: [email protected]

Other Services:

70M208

Avamere Living at Newberg

730 Foothills Drive

Yamhill

McMinnville NWSDS

Capacity: 70

Administrator: Sarah Cleesen

Facility Phone: (503) 554-0767

Facility Fax: (503) 554-0436

Owner: Genesis Newberg Operations Company, LLCCounty

Orig Lic. Date: 1999-04-08 Newberg, OR 97132

Renewal Date :2017-04-30 0

Units: 54

Management: Genesis Newberg Operations Company, LLC

Yes

Email: [email protected]

Other Services:

70M258

Avamere Living at St. Helens

2400 Gable Rd.

Columbia

St. Helens MSO

Capacity: 70

Administrator: Brett Woodyard

Facility Phone: (503) 366-8070

Facility Fax: (503) 366-8088

Owner: Avamere - St. Helens Operations, LLCCounty

Orig Lic. Date: 2001-03-12 St. Helens, OR 97051

Renewal Date :2017-03-31 0

Units: 52

Management: Avamere-St.Helens Operations, LLC

Yes

Email: [email protected]

Other Services:

70M008

Awbrey Place

2825 Neff Rd

Deschutes

Bend MSO

Capacity: 49

Administrator: Angela Kooistra

Facility Phone: (541) 317-8464

Facility Fax: (541) 317-4147

Owner: AWBREY AID OPCO, LLCCounty

Orig Lic. Date: 1995-11-18 Bend, OR 97701

Renewal Date :2017-07-31 0

Units: 46

Management: AWBREY AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

70M055

Azalea Gardens Senior Living

755 Elk Drive

Curry

Gold Beach MSO

Capacity: 42

Administrator: Shyrlee Stagner

Facility Phone: (541) 469-7182

Facility Fax: (541) 469-5672

Owner: Brookings Senior Living, LLCCounty

Orig Lic. Date: 1996-08-08 Brookings, OR 97415

Renewal Date :2018-06-30 0

Units: 36

Management: Mosaic Management, Inc.

Yes

Email: [email protected]

Other Services:

50R407

Bartlett House of Medford Memory Care Community

3465 Lone Pine Rd

Jackson

Medford SSO

Capacity: 15

Administrator: Christina Stanley

Facility Phone: (541) 245-9814

Facility Fax: (541) 245-9819

Owner: Pacific Living Centers, Inc.County

Orig Lic. Date: 2014-03-31 Medford, OR 97504

Renewal Date :2018-03-31 0

Units: 15

Management: Pacific Living Centers, Inc.

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 15

Tuesday, July 05, 2016 Page 10 of 85

Page 11: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A307

Bayberry Commons Assisted Living

2211 Laura Street

Lane

Eugene AAA

Capacity: 62

Administrator: Patty Neuman

Facility Phone: (541) 744-7000

Facility Fax: (541) 744-7999

Owner: Bayberry Commons, Inc.County

Orig Lic. Date: 2007-04-06 Springfield, OR 97477

Renewal Date :2017-04-30 0

Units: 48

Management: Ridgeline Management Co.

Yes

Email: [email protected]

Other Services:

50R347

Bayberry Commons Memory Care

2211 Laura Street

Lane

Eugene AAA

Capacity: 14

Administrator: Patty Neuman

Facility Phone: (541) 744-7000

Facility Fax: (541) 744-7999

Owner: Bayberry Commons, Inc.County

Orig Lic. Date: 2007-04-06 Springfield, OR 97477

Renewal Date :2017-04-30 0

Units: 14

Management: Ridgeline Management Co.

Yes

Email: [email protected]

Other Services: MCC, ACU 14

50M138

Baycrest Assisted Care

3959 Sheridan Ave

Coos

Coos Bay MSO

Capacity: 36

Administrator: Molly Laird

Facility Phone: (541) 756-4151

Facility Fax: (541) 751-7715

Owner: Bay Area Properties, LLCCounty

Orig Lic. Date: 1995-03-31 North Bend, OR 97459

Renewal Date :2016-12-31 0

Units: 30

Management: Radiant Senior Living, Inc.

Yes

Email: [email protected]

Other Services:

5MA215

Baycrest Memory Care

955 Kentucky Avenue

Coos

Coos Bay MSO

Capacity: 55

Administrator: Leslie Davis

Facility Phone: (541) 756-4151

Facility Fax: (541) 756-7715

Owner: Bay Area Properties, LLCCounty

Orig Lic. Date: 1998-03-26 Coos Bay, OR 97420

Renewal Date :2016-12-31 0

Units: 55

Management: Seasons Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 55

70M067

Bayside Terrace Assisted Living

192 Norman Ave

Coos

Coos Bay MSO

Capacity: 61

Administrator: Tyanna Handy

Facility Phone: (541) 888-2255

Facility Fax: (541) 888-5908

Owner: ARHC OCCOOOR01 TRS, LLCCounty

Orig Lic. Date: 1996-09-23 Coos Bay, OR 97420

Renewal Date :2017-08-31 0

Units: 47

Management: FM Ocean Crest, LLC

Yes

Email: [email protected]

Other Services:

50R408

Bee Hive Homes of Baker City

3078 Resort St.

Baker

Baker City APD

Capacity: 15

Administrator: Nicole Howerton

Facility Phone: (541) 403-3445

Facility Fax: (541) 523-1508

Owner: The Home Place in Baker, LLCCounty

Orig Lic. Date: 2014-04-11 Baker City, OR 97814

Renewal Date :2016-04-30 0

Units: 15

Management: Bee Hive Homes of Baker City

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 11 of 85

Page 12: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50M227

Blue Haven RCF - Dallas

280 SE Uglow St

Polk

Dallas NWSDS

Capacity: 16

Administrator: Tonya Smith

Facility Phone: (503) 623-0300

Facility Fax: (503) 588-7125

Owner: Blue Haven Residential Care Facilities, Inc.County

Orig Lic. Date: 1997-11-01 Dallas, OR 97338

Renewal Date :2017-07-31 0

Units: 16

Management: Blue Haven Residential Care Facilities, Inc.

Yes

Email: [email protected]

Other Services:

50M225

Blue Haven RCF - Independence

202 South 9th Street

Polk

Dallas NWSDS

Capacity: 16

Administrator: Shawna Stone

Facility Phone: (503) 910-5700

Facility Fax: (503) 390-5485

Owner: Blue Haven Residential Care Facilities, Inc.County

Orig Lic. Date: 1999-10-20 Independence, OR 97351

Renewal Date :2017-07-31 0

Units: 16

Management: Blue Haven Residential Care Facilities, Inc.

Yes

Email: [email protected]

Other Services:

70A235

Bonaventure of Albany Assisted Living

420 Geri Street

Linn

Albany

Capacity: 60

Administrator: Michelle Hampl

Facility Phone: (541) 497-5600

Facility Fax: (541) 497-5601

Owner: Mountain West Retirement CorporationCounty

Orig Lic. Date: 2015-12-07 Albany, OR 97321

Renewal Date :2017-12-31 0

Units: 54

Management: Bonaventure Senior Living

Non Medicaid

Email: [email protected]

Other Services:

50R430

Bonaventure of Albany Memory Care

420 Geri Street

Linn

Albany

Capacity: 23

Administrator: Luis Gonzalez Collazo

Facility Phone: (541) 497-5600

Facility Fax: (541) 497-5601

Owner: Mountain West Retirement CorporationCounty

Orig Lic. Date: 2015-12-07 Albany, OR 97321

Renewal Date :2017-12-31 0

Units: 22

Management: Bonaventure Senior Living

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 23

70A320

Bonaventure of Salem Assisted Living

3411 Boone Rd SE

Marion

Woodburn ADS

Capacity: 65

Administrator: McKenzie Worden

Facility Phone: (503) 480-0004

Facility Fax: (503) 480-0104

Owner: Bonaventure of Salem, LLCCounty

Orig Lic. Date: 2012-08-22 Salem, OR 97317

Renewal Date :2016-08-31 0

Units: 52

Management: Bonaventure Senior Living

Non Medicaid

Email: [email protected]

Other Services:

50R385

Bonaventure of Salem Memory Care

3411 Boone Rd SE

Marion

Woodburn ADS

Capacity: 24

Administrator: Darlene Chavez

Facility Phone: (503) 480-0004

Facility Fax: (503) 480-0104

Owner: Bonaventure of Salem, LLCCounty

Orig Lic. Date: 2012-08-22 Salem, OR 97317

Renewal Date :2016-08-31 0

Units: 24

Management: Bonaventure Senior Living

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 24

Tuesday, July 05, 2016 Page 12 of 85

Page 13: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A301

Bonaventure of Tigard Assisted Living

15000 SW Hall Blvd

Washington

Tigard

Capacity: 69

Administrator: Danielle Richardson

Facility Phone: (503) 214-4200

Facility Fax: (503) 214-4201

Owner: Bonaventure of Tigard, LLCCounty

Orig Lic. Date: 2016-02-17 Tigard, OR 97224

Renewal Date :2018-02-28 0

Units: 59

Management: Bonaventure Senior Living

Non Medicaid

Email: [email protected]

Other Services:

50R432

Bonaventure of Tigard Memory Care

15000 SW Hall Blvd

Washington

Tigard

Capacity: 23

Administrator: Monique Cruz

Facility Phone: (503) 214-4200

Facility Fax: (503) 214-4201

Owner: Bonaventure of Tigard, LLCCounty

Orig Lic. Date: 2016-02-17 Tigard, OR 97224

Renewal Date :2018-02-28 0

Units: 23

Management: Bonaventure Senior Living

Non Medicaid

Email: [email protected]

Other Services: ACU 23

70A266

Bridge Assisted Living, The

201 SW Bridge St.

Josephine

Grants Pass MSO

Capacity: 77

Administrator: Matt Tartaglio

Facility Phone: (541) 956-2110

Facility Fax: (541) 956-2109

Owner: Grants Pass Assisted Living, LLCCounty

Orig Lic. Date: 2001-09-18 Grants Pass, OR 97526

Renewal Date :2017-04-30 0

Units: 63

Management: Woollard Ipsen Management, LLC

Yes

Email: [email protected]

Other Services:

50A253

Bridgecreek Memory Care Community

1401 12th St

Linn

Albany SSO

Capacity: 58

Administrator: Casey Sharer

Facility Phone: (541) 259-1779

Facility Fax: (541) 259-2012

Owner: Bridgecreek Investors, LLCCounty

Orig Lic. Date: 2000-09-07 Lebanon, OR 97355

Renewal Date :2016-02-28 0

Units: 31

Management: Ageia Health Services, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 58

70M009

Bridgewood Rivers Assisted Living

1901 NW Hughwood

Douglas

Roseburg

Capacity: 50

Administrator: Teresa Courtney

Facility Phone: (541) 440-1914

Facility Fax: (541) 440-9009

Owner: Cascade Living Group - Oregon, LLCCounty

Orig Lic. Date: 1990-06-01 Roseburg, OR 97470

Renewal Date :2017-05-31 0

Units: 40

Management: Cascade Living Group, Inc.

Yes

Email: [email protected]

Other Services:

50R368

Brightcreek at Sea View

98059 Gerlach Lane

Curry

Brookings/Harbor SPD

Capacity: 35

Administrator: Stephenie Gideon

Facility Phone: (541) 469-4500

Facility Fax: (541) 469-4522

Owner: Sea View Assisted Living Community, LLCCounty

Orig Lic. Date: 2010-06-01 Brookings, OR 97415

Renewal Date :2016-10-31 0

Units: 19

Management: Seasons Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 35

Tuesday, July 05, 2016 Page 13 of 85

Page 14: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A062

Brookdale Ashland

548 North Main Street

Jackson

Medford

Capacity: 45

Administrator: Ryan Franko

Facility Phone: (541) 482-3292

Facility Fax: (541) 488-6988

Owner: Emeritus CorporationCounty

Orig Lic. Date: 1997-07-16 Ashland, OR 97520

Renewal Date :2016-08-31 0

Units: 38

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

50A232

Brookdale Beaverton

16655 NW Walker Rd

Washington

WCDAVS

Capacity: 60

Administrator: Wendy Trimbo

Facility Phone: (503) 439-1653

Facility Fax: (503) 439-1654

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 2000-01-25 Beaverton, OR 97006

Renewal Date :2017-11-30 0

Units: 52

Management: Brookdale Senior Living Communities, Inc.

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 60

50A263

Brookdale Bend

1099 NE Watt Way

Deschutes

Bend MSO

Capacity: 59

Administrator: Candace Nonnenmacher

Facility Phone: (541) 385-4717

Facility Fax: (541) 385-5232

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 2000-11-30 Bend, OR 97701

Renewal Date :2017-11-30 0

Units: 46

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 59

70A290

Brookdale Chestnut Lane - Gresham

1219 NE Sixth Street

Multnomah

Mid-Mult ASD

Capacity: 78

Administrator: Bradley Flynn

Facility Phone: (503) 674-0364

Facility Fax: (503) 674-9904

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2003-08-11 Gresham, OR 97030

Renewal Date :2016-08-31 0

Units: 70

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70M234

Brookdale Eagle Point

261 Loto Street

Jackson

Medford AAA

Capacity: 70

Administrator: Mandy Shelton

Facility Phone: (541) 830-0355

Facility Fax: (541) 830-0524

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2000-04-21 Eagle Point, OR 97524

Renewal Date :2016-08-31 0

Units: 62

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

50R279

Brookdale Eugene Alpine Court Memory Care

3720 N. Clarey St

Lane

Eugene SSO

Capacity: 64

Administrator: Cherie Long

Facility Phone: (541) 689-3900

Facility Fax: (541) 689-5622

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2001-06-13 Eugene, OR 97402

Renewal Date :2016-08-31 0

Units: 64

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 64

Tuesday, July 05, 2016 Page 14 of 85

Page 15: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M202

Brookdale Eugene Alpine Springs

3760 N. Clarey St.

Lane

Eugene SSO

Capacity: 80

Administrator: Michelle Eske-Page

Facility Phone: (541) 607-9525

Facility Fax: (541) 607-5589

Owner: Emeritus CorporationCounty

Orig Lic. Date: 1999-06-25 Eugene, OR 97402

Renewal Date :2016-08-31 0

Units: 70

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

5MA146

Brookdale Forest Grove

3110 19th Ave

Washington

WCDAVS

Capacity: 110

Administrator: Chris Budke

Facility Phone: (503) 357-3288

Facility Fax: (503) 359-1407

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 1980-01-01 Forest Grove, OR 97116

Renewal Date :2017-11-30 0

Units: 88

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70M016

Brookdale Geary Street

2445 Geary St SE

Linn

Albany SSO

Capacity: 80

Administrator: Trista Rinker

Facility Phone: (541) 926-8200

Facility Fax: (541) 926-8300

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 1997-07-01 Albany, OR 97321

Renewal Date :2017-11-30 0

Units: 70

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

50R403

Brookdale Geary Street Memory Care

2445 Geary St SE

Linn

Albany APD

Capacity: 44

Administrator: Doug Swaim

Facility Phone: (541) 926-8200

Facility Fax: (541) 926-8300

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 2014-04-10 Albany, OR 97321

Renewal Date :2018-04-30 0

Units: 32

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 44

5MA269

Brookdale Grants Pass Pointe

1400 Redwood Circle

Josephine

Grants Pass MSO

Capacity: 64

Administrator: Peggy Dias

Facility Phone: (541) 474-2838

Facility Fax: (541) 956-0190

Owner: S-H OpCo Spring Pointe, LLCCounty

Orig Lic. Date: 2001-03-15 Grants Pass, OR 97527

Renewal Date :2016-08-31 0

Units: 56

Management: BKD Twenty-One Management, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 64

70M254

Brookdale Grants Pass Village

1420 Redwood Circle

Josephine

Grants Pass MSO

Capacity: 90

Administrator: Deborah Vick

Facility Phone: (541) 474-0200

Facility Fax: (541) 474-5012

Owner: S-H OpCO Spring Village, LLCCounty

Orig Lic. Date: 2001-02-01 Grants Pass, OR 97527

Renewal Date :2016-08-31 0

Units: 83

Management: BKD Twenty-One Management, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 15 of 85

Page 16: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M040

Brookdale Hermiston

980 W Highland Ave

Umatilla

Hermiston MSO

Capacity: 63

Administrator: Lori Scheel

Facility Phone: (541) 567-3141

Facility Fax: (541) 567-7863

Owner: Emeritus CorporationCounty

Orig Lic. Date: 1996-05-16 Hermiston, OR 97838

Renewal Date :2016-08-31 0

Units: 57

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70A297

Brookdale Lebanon

181 South 5th Street

Linn

Albany SSO

Capacity: 95

Administrator: Dena Newton

Facility Phone: (541) 258-7706

Facility Fax: (541) 258-2233

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2005-12-09 Lebanon, OR 97355

Renewal Date :2016-08-31 0

Units: 83

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70M017

Brookdale McMinnville City Center

721 NE 27th St.

Yamhill

McMinnville NWSDS

Capacity: 50

Administrator: Crystale Harding

Facility Phone: (503) 435-0100

Facility Fax: (503) 435-0200

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 1998-05-19 McMinnville, OR 97128

Renewal Date :2017-11-30 0

Units: 41

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

5MA130

Brookdale McMinnville City Center Memory Care

721 NE 27th St.

Yamhill

McMinnville NWSDS

Capacity: 15

Administrator: Crystale Harding

Facility Phone: (503) 435-0100

Facility Fax: (503) 435-0200

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 1998-06-11 McMinnville, OR 97128

Renewal Date :2017-11-30 0

Units: 15

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services: ACU 15

50R078

Brookdale McMinnville Town Center

775 East 27th

Yamhill

McMinnville NWSDS

Capacity: 35

Administrator: Lara Egle

Facility Phone: (503) 472-3130

Facility Fax: (503) 434-5199

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 1991-07-01 McMinnville, OR 97128

Renewal Date :2017-11-30 0

Units: 27

Management: Brookdale Senior Living Communities, Inc.

Non Medicaid

Email: [email protected]

Other Services:

50M056

Brookdale Medford

3033 Barnett Rd

Jackson

Medford AAA

Capacity: 95

Administrator: Christina Konenakeaw

Facility Phone: (541) 776-7600

Facility Fax: (541) 776-0745

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 1980-01-01 Medford, OR 97504

Renewal Date :2017-11-30 0

Units: 78

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 16 of 85

Page 17: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M201

Brookdale Monmouth

504 Gwinn St E.

Polk

Dallas NWSDS

Capacity: 74

Administrator: Belinda Hamilton

Facility Phone: (503) 838-6850

Facility Fax: (503) 838-6443

Owner: Emeritus CorporationCounty

Orig Lic. Date: 1999-06-04 Monmouth, OR 97361

Renewal Date :2016-08-31 0

Units: 61

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

50M055

Brookdale Mt. Hood

25200 SE Stark St

Multnomah

E Mult ADS

Capacity: 88

Administrator: Jeri Gray

Facility Phone: (503) 665-4300

Facility Fax: (503) 674-7487

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 1991-06-19 Gresham, OR 97030

Renewal Date :2017-11-30 0

Units: 78

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70A308

Brookdale Newberg

3802 Hayes St.

Yamhill

McMinnville NWSDS

Capacity: 110

Administrator: Amanda Bristow

Facility Phone: (503) 538-1705

Facility Fax: (503) 538-1905

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2007-06-29 Newberg, OR 97132

Renewal Date :2016-08-31 0

Units: 83

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

50M142

Brookdale Ontario

1372 SW 8th Ave

Malheur

Ontario MSO

Capacity: 82

Administrator: Brandy Perry

Facility Phone: (541) 889-4600

Facility Fax: (541) 889-3291

Owner: Emeritus CorporationCounty

Orig Lic. Date: 1995-05-11 Ontario, OR 97914

Renewal Date :2017-09-30 0

Units: 53

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70A303

Brookdale Oswego Springs - Portland

11552 SW Lesser Rd.

Multnomah

W Portland AAA

Capacity: 82

Administrator: Cindy Plaza

Facility Phone: (503) 542-4747

Facility Fax: (503) 542-4848

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2006-04-12 Portland, OR 97219

Renewal Date :2016-08-31 0

Units: 75

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70M070

Brookdale Park Place - Tigard

8445 SW Hemlock St

Washington

WCDAVS

Capacity: 130

Administrator: Ryan Duve

Facility Phone: (503) 245-8985

Facility Fax: (503) 246-2689

Owner: Emeritus CorporationCounty

Orig Lic. Date: 1990-02-01 Portland, OR 97223

Renewal Date :2016-08-31 0

Units: 112

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 17 of 85

Page 18: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A305

Brookdale Redmond Assisted Living

1942 SW Canyon Drive

Deschutes

Redmond SPD

Capacity: 77

Administrator: Donna Hawley

Facility Phone: (541) 316-4400

Facility Fax: (541) 316-4401

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2006-11-09 Redmond, OR 97756

Renewal Date :2016-08-31 0

Units: 62

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

50R344

Brookdale Redmond Clare Bridge

1942 SW Canyon Drive

Deschutes

Redmond SPD

Capacity: 32

Administrator: Donna Hawley

Facility Phone: (541) 316-4400

Facility Fax: (541) 316-4401

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2006-11-20 Redmond, OR 97756

Renewal Date :2016-08-31 0

Units: 24

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services: ACU 32

70M078

Brookdale River Road

592 Bever Dr NE

Marion

Salem NWSDS

Capacity: 56

Administrator: Alicia Sykes

Facility Phone: (503) 463-4060

Facility Fax: (503) 304-3090

Owner: Emeritus CorporationCounty

Orig Lic. Date: 1998-07-17 Keizer, OR 97303

Renewal Date :2016-09-30 0

Units: 49

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

50M054

Brookdale River Valley - Tualatin

19200 SW 65th Ave

Clackamas

Canby SPD

Capacity: 120

Administrator: Howard Dunkley

Facility Phone: (503) 692-3192

Facility Fax: (503) 691-9836

Owner: Emeritus CorporationCounty

Orig Lic. Date: 1989-03-01 Tualatin, OR 97062

Renewal Date :2016-08-31 0

Units: 114

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 26

70M236

Brookdale Rose Valley Scappoose

33800 SE Frederick Street

Columbia

St. Helens MSO

Capacity: 79

Administrator: Steven Matthews

Facility Phone: (503) 543-4646

Facility Fax: (503) 543-4648

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2000-05-15 Scappoose, OR 97056

Renewal Date :2016-08-31 0

Units: 64

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

5MA254

Brookdale Roseburg

3400 NW Edenbower Blvd.

Douglas

Roseburg AAA

Capacity: 60

Administrator: Sarah Calvert

Facility Phone: (541) 464-5600

Facility Fax: (541) 464-5858

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2000-09-07 Roseburg, OR 97470

Renewal Date :2016-08-31 0

Units: 56

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 60

Tuesday, July 05, 2016 Page 18 of 85

Page 19: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

5MA205

Brookdale Salem

1355 Boone Rd SE

Marion

Salem NWSDS

Capacity: 60

Administrator: Natalie Nelson

Facility Phone: (503) 365-7500

Facility Fax: (503) 365-7600

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 1999-05-19 Salem, OR 97302

Renewal Date :2017-11-30 0

Units: 52

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 60

70A295

Brookdale Sellwood

8517 SE 17th Avenue

Multnomah

SE Portland ASO

Capacity: 100

Administrator: Lana Buckles

Facility Phone: (503) 542-4800

Facility Fax: (503) 542-4801

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2005-06-16 Portland, OR 97202

Renewal Date :2016-08-31 0

Units: 85

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70A299

Brookdale Springfield Briarwood

4865 Main Street

Lane

Eugene AAA

Capacity: 150

Administrator: Charity Bobbitt

Facility Phone: (541) 284-2865

Facility Fax: (541) 284-2864

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2006-03-01 Springfield, OR 97478

Renewal Date :2016-08-31 0

Units: 122

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70M226

Brookdale Springfield Woodside

4851 Main Street

Lane

Eugene SSO

Capacity: 62

Administrator: Abby Grimps

Facility Phone: (541) 747-1887

Facility Fax: (541) 747-0181

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2000-01-21 Springfield, OR 97478

Renewal Date :2016-08-31 0

Units: 53

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70M251

Brookdale Stayton

2201 3rd Ave.

Marion

Salem NWSDS

Capacity: 75

Administrator: Amanda Villarreal

Facility Phone: (503) 769-3200

Facility Fax: (503) 769-1286

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2000-11-15 Stayton, OR 97383

Renewal Date :2016-08-31 0

Units: 62

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

50A236

Brookdale Troutdale

1201 SW Cherry Park Rd.

Multnomah

E. County ASD

Capacity: 60

Administrator: Olivia Peneyra

Facility Phone: (503) 465-8104

Facility Fax: (503) 465-8204

Owner: Brookdale Senior Living Communities, Inc.County

Orig Lic. Date: 2000-03-01 Troutdale, OR 97060

Renewal Date :2017-11-30 0

Units: 52

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 60

Tuesday, July 05, 2016 Page 19 of 85

Page 20: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50M228

Brookdale Wilsonville

8170 Vlahos Drive

Clackamas

Milwaukie SPD

Capacity: 32

Administrator: Kathy White

Facility Phone: (503) 682-0653

Facility Fax: (503) 570-1034

Owner: Emeritus CorporationCounty

Orig Lic. Date: 1999-10-21 Wilsonville, OR 97070

Renewal Date :2016-08-31 0

Units: 27

Management: Brookdale Senior Living Communities, Inc.

Yes

Email: [email protected]

Other Services:

70M010

Brookside Place

3550 SW Canal Blvd

Deschutes

Bend MSO

Capacity: 45

Administrator: Deanna Boire

Facility Phone: (541) 504-1600

Facility Fax: (541) 504-1602

Owner: Redmond ALF, Inc.County

Orig Lic. Date: 1995-03-03 Redmond, OR 97756

Renewal Date :2017-01-31 0

Units: 37

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

5MA151

Brookstone Alzheimer's Special Care Center

5881 SE Woodside Dr

Marion

Salem NWSDS

Capacity: 57

Administrator: Richard Howard

Facility Phone: (503) 316-0687

Facility Fax: (503) 589-1753

Owner: Salem Associates LLCCounty

Orig Lic. Date: 1996-08-10 Salem, OR 97301

Renewal Date :2016-08-31 0

Units: 39

Management: Jerry Erwin Associates, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 57

5MA240

Callahan Court Memory Care Comm.

1770 NW Valley View Drive

Douglas

Roseburg AAA

Capacity: 48

Administrator: Kim Jordan

Facility Phone: (541) 673-3900

Facility Fax: (541) 673-3105

Owner: LSREF Golden Ops 14(OR) LLCCounty

Orig Lic. Date: 2000-03-23 Roseburg, OR 97470

Renewal Date :2017-01-31 0

Units: 48

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 48

70M229

Callahan Village

1801 Garden Valley Blvd.

Douglas

Roseburg

Capacity: 86

Administrator: Tammy Huntley

Facility Phone: (541) 673-4500

Facility Fax: (541) 672-1346

Owner: LSREF Golden Ops UE (OR) LLCCounty

Orig Lic. Date: 2000-02-04 Roseburg, OR 97470

Renewal Date :2017-01-31 0

Units: 71

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

70M247

Cambridge Terrace Assisted Living

2800 14th Ave. SE

Linn

Albany SSO

Capacity: 60

Administrator: Luis Gonzalez Collazo

Facility Phone: (541) 928-9494

Facility Fax: (541) 812-9198

Owner: Albany Assisted Living LLCCounty

Orig Lic. Date: 2000-10-06 Albany, OR 97321

Renewal Date :2016-10-31 0

Units: 50

Management: Bonaventure Senior Living

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 20 of 85

Page 21: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A011

Canfield Place Retirement Community

14570 SW Hart Rd

Washington

WCDAVS

Capacity: 105

Administrator: Lauren Spangler

Facility Phone: (503) 626-5100

Facility Fax: (503) 526-3803

Owner: Canfield Place Rtrmt Comm LLCCounty

Orig Lic. Date: 1996-08-06 Beaverton, OR 97005

Renewal Date :2018-07-31 0

Units: 88

Management: Leisure Care, LLC

Non Medicaid

Email: [email protected]

Other Services:

70A296

Canyon Rim Manor

1701 George Jackson Rd.

Wasco

The Dalles AAA

Capacity: 35

Administrator: Corrie Lemon

Facility Phone: (541) 395-2515

Facility Fax: (541) 395-0937

Owner: Maupin Senior Living, LLCCounty

Orig Lic. Date: 2005-11-18 Maupin, OR 97037

Renewal Date :2017-07-31 0

Units: 27

Management: Mosaic Management, Inc.

Yes

Email: [email protected]

Other Services:

50R216

Capital Manor Retirement Community

1955 Salem Dallas Hwy NW

Polk

Salem NWSDS

Capacity: 102

Administrator: Carolyn Creighton

Facility Phone: (503) 362-4101

Facility Fax: (503) 371-9021

Owner: Capital Manor, Inc.County

Orig Lic. Date: 1999-01-19 Salem, OR 97304

Renewal Date :2017-05-31 0

Units: 73

Management: Life Care Services, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 21

70M013

Carriage Place

150 S Williamson Dr

Crook

Prineville MSO

Capacity: 34

Administrator: Kira Buresh

Facility Phone: (541) 416-0500

Facility Fax: (541) 416-1445

Owner: CARRIAGE AID OPCO, LLCCounty

Orig Lic. Date: 1995-10-27 Prineville, OR 97754

Renewal Date :2017-07-31 0

Units: 30

Management: CARRIAGE AID OPCO, LLC

Yes

Email: [email protected]

Other Services:

50M012

Cascade Park Retirement Center

950 N Cascade Dr

Marion

Woodburn NWSDS

Capacity: 32

Administrator: Elaine Rust

Facility Phone: (503) 981-0033

Facility Fax: (503) 982-2707

Owner: Woodburn Investment Associates, Ltd.County

Orig Lic. Date: 1991-06-09 Woodburn, OR 97071

Renewal Date :2017-08-31 0

Units: 28

Management: Century Park Associates, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R128

Cascades of Bend Retirement Community

1801 NE Lotus Dr

Deschutes

Bend MSO

Capacity: 70

Administrator: Jamie Maul

Facility Phone: (541) 389-0046

Facility Fax: (541) 382-1239

Owner: Cascade Living Group - Oregon, LLCCounty

Orig Lic. Date: 1982-01-01 Bend, OR 97701

Renewal Date :2017-05-31 0

Units: 35

Management: Cascade Living Group, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 21 of 85

Page 22: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M228

Cascadia Village Retirement Comm.

39495 Cascadia Village Drive

Clackamas

Clackamas AAA

Capacity: 55

Administrator: Michael Ball

Facility Phone: (503) 668-0300

Facility Fax: (503) 668-1154

Owner: Sandy Assisted Living, LLCCounty

Orig Lic. Date: 2000-02-04 Sandy, OR 97055

Renewal Date :2018-02-28 0

Units: 50

Management: Bonaventure Senior Living

Yes

Email: [email protected]

Other Services:

5MA207

Cedar Crest Alzheimer Special Care

18325 SW Pacific HWY

Washington

WCDAVS

Capacity: 56

Administrator: Todd Whitehead

Facility Phone: (503) 925-0544

Facility Fax: (503) 625-2301

Owner: Tualatin Associates, LLCCounty

Orig Lic. Date: 1999-04-28 Tualatin, OR 97062

Renewal Date :2017-04-30 0

Units: 30

Management: JEA Senior Living

Yes

Email: [email protected]

Other Services: MCC, ACU 56

70M222

Cedar Village Assisted Living Community

4452 Lancaster Dr. NE

Marion

Salem NWSDS

Capacity: 62

Administrator: Janie Kellett

Facility Phone: (503) 390-9600

Facility Fax: (503) 390-9152

Owner: ARHC CVSALOR01 TRS, LLCCounty

Orig Lic. Date: 1999-10-22 Salem, OR 97305

Renewal Date :2017-07-31 0

Units: 51

Management: FM Cedar Village, LLC

Yes

Email: [email protected]

Other Services:

50R353

Cedar Village Memory Care Community

4452 Lancaster Drive NE

Marion

Salem NWSDS

Capacity: 24

Administrator: Kimberlee Brooks

Facility Phone: (503) 390-9600

Facility Fax: (503) 390-9152

Owner: ARHC CVSALOR01 TRS, LLCCounty

Orig Lic. Date: 2008-01-15 Salem, OR 97301

Renewal Date :2017-07-31 0

Units: 18

Management: FM Cedar Village, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 24

50R351

Chantele's Loving Touch Memory Care

1128 W. Central Avenue

Douglas

Roseburg AAA

Capacity: 45

Administrator: Chantele Bangs

Facility Phone: (541) 459-4549

Facility Fax: (541) 459-2187

Owner: Chantele's Loving Touch Memory Care, Inc.County

Orig Lic. Date: 2007-11-06 Sutherlin, OR 97479

Renewal Date :2017-11-30 0

Units: 39

Management: Chantele's Loving Touch Memory Care, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 45

50M172

Chateau Gardens Memory Care Community

2669 S Cloverleaf Loop

Lane

Eugene SSO

Capacity: 28

Administrator: Kim Frederick

Facility Phone: (541) 746-9703

Facility Fax: (541) 744-7017

Owner: Cloverleaf Assisted Living, LLCCounty

Orig Lic. Date: 1993-12-08 Springfield, OR 97477

Renewal Date :2017-12-31 0

Units: 22

Management: Ridgeline Management Co.

Yes

Email: [email protected]

Other Services: MCC, ACU 28

Tuesday, July 05, 2016 Page 22 of 85

Page 23: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R014

Cherry Blossom Cottage

11177 SE Cherry Blossom Dr

Multnomah

Mid-County ASD

Capacity: 49

Administrator: Rebecca Meadowcroft

Facility Phone: (503) 256-9777

Facility Fax: (503) 256-0047

Owner: Sylvia's Legacy, Inc.County

Orig Lic. Date: 1989-05-28 Portland, OR 97216

Renewal Date :2017-05-31 0

Units: 40

Management: Sylvia's Legacy, Inc.

Non Medicaid

Email: [email protected]

Other Services:

50R389

Cherry Park Plaza

1323 SW Cherry Park Road

Multnomah

East ADS

Capacity: 33

Administrator: Roberta Bradfield

Facility Phone: (503) 491-1661

Facility Fax:

Owner: CHGCXA Troutdale, LLCCounty

Orig Lic. Date: 2013-04-12 Troutdale, OR 97060

Renewal Date :2017-04-30 0

Units: 23

Management: CHG Management Company I, LLC

Non Medicaid

Email: [email protected]

Other Services: MC, ACU 14

50R416

Cherrywood Memory Care, The

2750 NE Doran Drive

Yamhill

McMinnville

Capacity: 56

Administrator: Denise Stoutenburg

Facility Phone: (503) 309-6202

Facility Fax: (503) 883-9462

Owner: Cherrywood, Inc., TheCounty

Orig Lic. Date: 2015-04-10 McMinnville, OR 97128

Renewal Date :2017-04-30 0

Units: 35

Management: Cherrywood, Inc., The

Yes

Email: [email protected]

Other Services: MCC, ACU 56

50M208

Chetco Inn Residential Care Facility

417 Fern St

Curry

Gold Beach MSO

Capacity: 37

Administrator: Donald Werner

Facility Phone: (541) 469-5347

Facility Fax: (541) 469-5348

Owner: Chetco Inn RCF IncorporatedCounty

Orig Lic. Date: 1994-11-23 Brookings, OR 97415

Renewal Date :2017-08-31 0

Units: 36

Management: Chetco Inn RCF Incorporated

Yes

Email: [email protected]

Other Services:

70M004

Chinook Place

470 NE Oak St

Jefferson

Bend MSO

Capacity: 12

Administrator: Rosie Griggs

Facility Phone: (541) 475-6425

Facility Fax: (541) 475-6001

Owner: ASPEN COURT AID OPCO, LLCCounty

Orig Lic. Date: 1991-02-01 Madras, OR 97741

Renewal Date :2017-07-31 0

Units: 12

Management: ASPEN COURT AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

70M014

Churchill Estates Assisted Living

1919 Bailey Hill Rd

Lane

Eugene SSO

Capacity: 48

Administrator: Kristina Becker

Facility Phone: (541) 485-8320

Facility Fax: (541) 485-8405

Owner: Churchill Management, Inc.County

Orig Lic. Date: 1991-02-11 Eugene, OR 97405

Renewal Date :2016-07-31 0

Units: 44

Management: Churchill Retirement Services, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 23 of 85

Page 24: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R365

Churchill Estates Residential Care

3800 Westleigh

Lane

Eugene SSO

Capacity: 108

Administrator: Deborah Hankins

Facility Phone: (541) 485-8320

Facility Fax: (541) 344-0215

Owner: Churchill Management, Inc.County

Orig Lic. Date: 2009-12-31 Eugene, OR 97405

Renewal Date :2016-07-31 0

Units: 58

Management: Churchill Retirement Services, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 44

50R139

Clackamas View Senior Living - Milwaukie

14550 SE Vista Ln

Clackamas

Clackamas AAA

Capacity: 40

Administrator: Kimberly Young

Facility Phone: (503) 659-2325

Facility Fax: (503) 652-4376

Owner: Chancellor Health Care of California X, Inc.County

Orig Lic. Date: 1995-04-01 Milwaukie, OR 97267

Renewal Date :2016-10-31 0

Units: 25

Management: Chancellor Health Care, Inc,

Non Medicaid

Email: [email protected]

Other Services:

5MA016

Clarendon Court Alzheimer's Residence

5732 SE 122nd Ave

Multnomah

E Portland ASD

Capacity: 15

Administrator: Loredana Horga

Facility Phone: (503) 761-3434

Facility Fax: (503) 206-6950

Owner: Clarendon Court Alzheimer's Residence, LLCCounty

Orig Lic. Date: 1984-03-01 Portland, OR 97236

Renewal Date :2017-01-31 0

Units: 15

Management: Clarendon Court Alzheimer's Residence, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 15

50R421

Clatsop Care Memory Community

2219 SE Dolphin Road

Clatsop

NWSDS

Capacity: 32

Administrator: Mindy Stokes

Facility Phone: (503) 468-0904

Facility Fax: (503) 468-0103

Owner: Clatsop Care Center Health DistrictCounty

Orig Lic. Date: 2015-07-01 Warrenton, OR 97146

Renewal Date :2017-07-31 0

Units: 32

Management: Clatsop Care Center Health District

Yes

Email: [email protected]

Other Services: MCC, ACU 32

70M203

Clatsop Retirement Village

947 Olney Ave.

Clatsop

Warrenton NWSDS

Capacity: 80

Administrator: Elizabeth Rathfon

Facility Phone: (503) 325-4676

Facility Fax: (503) 325-4646

Owner: Clatsop Care Center Health DistrictCounty

Orig Lic. Date: 1999-07-19 Astoria, OR 97103

Renewal Date :2017-07-31 0

Units: 69

Management: Clatsop Care Center Health District

Yes

Email: [email protected]

Other Services:

50M021

Comfort Care

1735 Kane St

Klamath

Klamath Falls MSO

Capacity: 16

Administrator: Mary Nork

Facility Phone: (541) 883-2882

Facility Fax: (541) 884-1616

Owner: Mary NorkCounty

Orig Lic. Date: 1993-10-31 Klamath Falls, OR 97603

Renewal Date :2017-10-31 0

Units: 8

Management: Mary Nork

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 24 of 85

Page 25: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R023

Conifer House Residential Care & Memory Care

145 NE Conifer Blvd

Benton

Albany SSO

Capacity: 51

Administrator: Susan Jensen

Facility Phone: (541) 757-2444

Facility Fax: (541) 757-8621

Owner: Conifer House Operating Company, LLCCounty

Orig Lic. Date: 1987-08-01 Corvallis, OR 97330

Renewal Date :2016-08-31 0

Units: 32

Management: Benicia Senior Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 32

50R404

Coral Springs Residential Care

2520 Coral Ave. NE

Marion

Salem NWSDS

Capacity: 32

Administrator: Heather Arnason

Facility Phone: (503) 362-5885

Facility Fax: (503) 362-8008

Owner: Sweet Bye N Bye AFC & RCF Facilities, Inc.County

Orig Lic. Date: 2014-03-26 Salem, OR 97305

Renewal Date :2018-03-31 0

Units: 32

Management: Sweet Bye N Bye AFC & RCF Facilities, Inc.

Non Medicaid

Email: [email protected]

Other Services:

70M015

Cornell Estates Retirement and Assisted Living Residence

1005 NE 17th

Washington

WCDAVS

Capacity: 75

Administrator: Charlene Torrey

Facility Phone: (503) 640-2884

Facility Fax: (503) 681-2784

Owner: Cornell Investors Group Inc.County

Orig Lic. Date: 1991-06-01 Hillsboro, OR 97123

Renewal Date :2017-05-31 0

Units: 59

Management: Cornell Investors Group, Inc.

Yes

Email: [email protected]

Other Services:

50R346

Cornerstone Residential Option

12640 SE Bush

Multnomah

E County AAA

Capacity: 16

Administrator: Milissa Wright

Facility Phone: (503) 761-6621

Facility Fax: (503) 761-6633

Owner: Cornerstone Care Option, IncCounty

Orig Lic. Date: 2006-12-26 Portland, OR 97236

Renewal Date :2016-12-31 0

Units: 16

Management: Cornerstone Care Option, Inc.

Yes

Email: [email protected]

Other Services:

70A280

Corvallis Caring Place Assisted Living

750 NW 23rd St

Benton

Albany SSO

Capacity: 55

Administrator: Lorene Hales

Facility Phone: (541) 753-2033

Facility Fax: (541) 753-2034

Owner: Corvallis Caring Place, Inc.County

Orig Lic. Date: 2002-06-28 Corvallis, OR 97330

Renewal Date :2018-06-30 0

Units: 42

Management: Mennonite Management Services, Inc.

Yes

Email: [email protected]

Other Services:

70A285

Country Meadows Village

155 S. Evergreen

Marion

Salem NWSDS

Capacity: 50

Administrator: Diane Matheny

Facility Phone: (971) 983-1424

Facility Fax: (971) 983-3222

Owner: Crown II Development, LLCCounty

Orig Lic. Date: 2002-12-12 Woodburn, OR 97071

Renewal Date :2017-04-30 0

Units: 40

Management: Crown Two Development, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 25 of 85

Page 26: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R283

Countryside Living of Canby

390 NW 2nd

Clackamas

Canby SPD

Capacity: 35

Administrator: Brittany Schwabauer

Facility Phone: (503) 266-3031

Facility Fax: (503) 266-4000

Owner: Countryside Living of Canby, LLCCounty

Orig Lic. Date: 2001-09-06 Canby, OR 97013

Renewal Date :2017-09-30 0

Units: 21

Management: Countryside Living of Canby, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 35

50M426

Countryside Living of Redmond

1350 NW Canal Blvd

Deschutes

Redmond

Capacity: 35

Administrator: Barbara Thompson

Facility Phone: (541) 548-3049

Facility Fax: (541) 548-9984

Owner: Countryside Living of Redmond, LLCCounty

Orig Lic. Date: 2016-01-07 Redmond, OR 97756

Renewal Date :2018-01-31 0

Units: 20

Management: Countryside Living of Redmond, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 35

50R380

Countryside Living South

406 NW 2nd Avenue

Clackamas

Canby SPD

Capacity: 20

Administrator: Leah Marroquin

Facility Phone: (503) 266-3031

Facility Fax: (503) 266-4000

Owner: Countryside Living of Canby, LLCCounty

Orig Lic. Date: 2011-09-13 Canby, OR 97013

Renewal Date :2017-09-30 0

Units: 16

Management: Countryside Living of Canby, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 20

70A318

Countryside Village

1700 Kellenbeck Rd.

Josephine

Grants Pass DSO

Capacity: 22

Administrator: Sherri Scott

Facility Phone: (541) 956-0999

Facility Fax: (541) 471-1182

Owner: Lynn-Ann Development, LLCCounty

Orig Lic. Date: 2011-09-02 Grants Pass, OR 97528

Renewal Date :2017-09-30 0

Units: 16

Management: Lynn-Ann Development, LLC

Yes

Email: [email protected]

Other Services:

50R277

Courtyard at Hillside Memory Care

300 NW Hillside Park Way

Yamhill

McMinnville NWSDS

Capacity: 20

Administrator: Denise Olson

Facility Phone: (503) 472-9534

Facility Fax: (503) 888-7477

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2001-05-01 McMinnville, OR 97128

Renewal Date :2016-08-31 0

Units: 20

Management: Emeritus Corporation

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 20

70M239

Courtyard at Mt. Tabor

6323 SE Division

Multnomah

SE Portland ASO

Capacity: 80

Administrator: Ashley Gomez

Facility Phone: (503) 772-9795

Facility Fax: (503) 788-8711

Owner: Courtyard Assisted Members, LLCCounty

Orig Lic. Date: 2000-08-07 Portland, OR 97206

Renewal Date :2016-08-31 0

Units: 73

Management: Integral Senior Living, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 26 of 85

Page 27: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

5MA252

Courtyard at Mt.Tabor Garden House

6323 SE Division

Multnomah

SE Portland ASO

Capacity: 24

Administrator: Gerald Koll, Jr.

Facility Phone: (503) 772-9795

Facility Fax: (503) 788-8711

Owner: Courtyard Assisted Members, LLCCounty

Orig Lic. Date: 2000-08-24 Portland, OR 97206

Renewal Date :2016-08-31 0

Units: 20

Management: Integral Senior Living, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 20

70A315

Courtyard Fountains Assisted Living Community

1537 SE 223rd

Multnomah

E Multnomah ADS

Capacity: 49

Administrator: William Michaels

Facility Phone: (503) 667-4500

Facility Fax: (503) 667-3978

Owner: ARHC CFGREOR01 TRS, LLCCounty

Orig Lic. Date: 2010-05-17 Gresham, OR 97030

Renewal Date :2017-12-31 0

Units: 44

Management: Courtyard Fountains Care Properties, LLC

Non Medicaid

Email: [email protected]

Other Services:

5MA024

Curry Manor

1458 Quail Lane

Douglas

Roseburg AAA

Capacity: 62

Administrator: Jan Sullivan

Facility Phone: (541) 673-3999

Facility Fax: (541) 440-9684

Owner: TSL Curry Manor, LLCCounty

Orig Lic. Date: 1982-11-01 Roseburg, OR 97470

Renewal Date :2017-11-30 0

Units: 62

Management: Tierra Senior Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 47

70M018

Dallas Retirement Village Assisted Living

340 NW Brentwood St

Polk

Dallas NWSDS

Capacity: 53

Administrator: Elizabeth "Karri" Key

Facility Phone: (503) 831-0214

Facility Fax: (503) 831-0278

Owner: Dallas Mennonite Retirement Community, Inc.County

Orig Lic. Date: 1996-09-30 Dallas, OR 97338

Renewal Date :2016-09-30 0

Units: 45

Management: Life Care Services

Yes

Email: [email protected]

Other Services:

70A321

Dallas Retirement Village Assisted Living HUD

377 NW Jasper St

Polk

Dallas NWSDS

Capacity: 25

Administrator: Elizabeth "Karri" Key

Facility Phone: (503) 623-5581

Facility Fax: (503) 623-2901

Owner: Dallas Health Care Center, LLCCounty

Orig Lic. Date: 2013-01-01 Dallas, OR 97338

Renewal Date :2017-01-31 0

Units: 20

Management: Life Care Services

Yes

Email: [email protected]

Other Services:

50R331

Dallas Retirement Village Memory Care Center

340 NW Brentwood Avenue

Polk

Dallas NWSDS

Capacity: 20

Administrator: Alycia Williamson

Facility Phone: (503) 623-5581

Facility Fax: (503) 623-2901

Owner: Dallas Health Care Center, LLCCounty

Orig Lic. Date: 2004-10-11 Dallas, OR 97338

Renewal Date :2017-01-31 0

Units: 20

Management: Life Care Services

Yes

Email: [email protected]

Other Services: MCC, ACU 20

Tuesday, July 05, 2016 Page 27 of 85

Page 28: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M019

Davenport Place

930 Oak St

Marion

Woodburn NWSDS

Capacity: 36

Administrator: Tammy O'Rourke

Facility Phone: (503) 873-7162

Facility Fax: (503) 873-6672

Owner: DAVENPORT AID OPCO, LLCCounty

Orig Lic. Date: 1995-07-25 Silverton, OR 97381

Renewal Date :2017-07-31 0

Units: 30

Management: DAVENPORT AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

70M250

Deer Meadow Assisted Living Community

1350 W Main St

Yamhill

McMinnville NWSDS

Capacity: 68

Administrator: Jennifer Abraham

Facility Phone: (503) 843-7799

Facility Fax: (503) 843-2112

Owner: Aspen Foundation IIICounty

Orig Lic. Date: 2000-11-06 Sheridan, OR 97378

Renewal Date :2016-11-30 0

Units: 53

Management: Aspen Foundation III

Yes

Email: jabraham.deermeadow@aspencommunities.

Other Services:

70M020

Deerfield Village Assisted Living

5770 SE Kellogg Cr Dr

Clackamas

Milwaukie SPD

Capacity: 48

Administrator: Lanelle Veile

Facility Phone: (503) 653-4064

Facility Fax: (503) 659-4525

Owner: Cascade Living Group - Oregon, LLCCounty

Orig Lic. Date: 1991-11-04 Milwaukie, OR 97222

Renewal Date :2017-05-31 0

Units: 40

Management: Cascade Living Group, Inc.

Yes

Email: [email protected]

Other Services:

50M048

Donham Place

5833 N Lombard St

Multnomah

NE Portland ASO/DSO

Capacity: 13

Administrator: John Varner

Facility Phone: (503) 283-2852

Facility Fax: (503) 283-4868

Owner: Donham Place, LLCCounty

Orig Lic. Date: 1974-01-01 Portland, OR 97203

Renewal Date :2017-10-31 0

Units: 13

Management: Donham Place, LLC

Yes

Email: [email protected]

Other Services:

70M021

Dorian Place Assisted Living Facility

375 N Dorian Dr

Malheur

Ontario MSO

Capacity: 50

Administrator: Nancy Hollis

Facility Phone: (541) 889-8545

Facility Fax: (541) 889-7340

Owner: Dorian Place Operations, LLCCounty

Orig Lic. Date: 1995-07-19 Ontario, OR 97914

Renewal Date :2016-12-31 0

Units: 45

Management: Milestone Retirement Communities, LLC

Yes

Email: [email protected]

Other Services:

50R334

East Cascade Memory Care Community

175 NE 16th Street

Jefferson

Madras SPD

Capacity: 16

Administrator: Shantel Vasquez

Facility Phone: (541) 475-2273

Facility Fax: (541) 475-4289

Owner: East Cascade Retirement Community, LLCCounty

Orig Lic. Date: 2005-09-23 Madras, OR 97741

Renewal Date :2017-01-31 0

Units: 12

Management: Senior Housing Managers, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 16

Tuesday, July 05, 2016 Page 28 of 85

Page 29: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M212

East Cascade Retirement Community

175 NE 16th Street

Jefferson

Madras MSO

Capacity: 48

Administrator: Randy Mondello

Facility Phone: (541) 475-2273

Facility Fax: (541) 475-4289

Owner: East Cascade Retirement Community, LLCCounty

Orig Lic. Date: 1999-04-06 Madras, OR 97741

Renewal Date :2017-01-31 0

Units: 48

Management: Senior Housing Managers, LLC

Yes

Email: [email protected]

Other Services:

50R276

Edgewood Arbor Memory Care

7733 SW Scholls Ferry Rd.

Washington

WCDAVS

Capacity: 27

Administrator: Billie Wingfield

Facility Phone: (503) 671-9474

Facility Fax: (503) 671-9245

Owner: Beaverton Assisted Living, LLCCounty

Orig Lic. Date: 2001-05-01 Beaverton, OR 97008

Renewal Date :2017-05-31 0

Units: 16

Management: Hawthorn Retirement Group, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 27

70A261

Edgewood Point Assisted Living

7733 SW Scholls Ferry Rd

Washington

WCDAVS

Capacity: 59

Administrator: Billie Wingfield

Facility Phone: (503) 671-9474

Facility Fax: (503) 671-9245

Owner: Beaverton Assisted Living, LLCCounty

Orig Lic. Date: 2001-04-13 Beaverton, OR 97008

Renewal Date :2017-04-30 0

Units: 49

Management: Hawthorn Retirement Group, LLC

Yes

Email: [email protected]

Other Services:

50R280

Elderberry Square Community

3321 Oak St

Lane

Florence AAA

Capacity: 48

Administrator: Christi Schuster

Facility Phone: (541) 902-8821

Facility Fax: (541) 902-8615

Owner: Elderberry Square Community, LLCCounty

Orig Lic. Date: 2001-06-28 Florence, OR 97439

Renewal Date :2016-11-30 0

Units: 48

Management: Senior Housing Managers, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 32

5ME119

ElderHealth & Living

382-B South 58th St

Lane

Eugene SSO

Capacity: 95

Administrator: Nancy Koll

Facility Phone: (541) 747-4858

Facility Fax: (541) 747-5322

Owner: ElderHealth & Living CorporationCounty

Orig Lic. Date: 1991-08-01 Springfield, OR 97478

Renewal Date :2016-08-31 0

Units: 58

Management: ElderHealth & Living Corporation

Yes

Email: [email protected]

Other Services: MCC, ACU 95

50M025

Elderly Care Home

12435 SW 121st

Washington

WCDAVS

Capacity: 15

Administrator: Sarah Mahinay

Facility Phone: (503) 590-9854

Facility Fax: (503) 590-4659

Owner: Elderly Care Home, Inc.County

Orig Lic. Date: 1993-06-22 Tigard, OR 97223

Renewal Date :2018-03-31 0

Units: 10

Management: Elderly Care Home, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 29 of 85

Page 30: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R405

Elite Care Oatfield Estates Larch House

4405 SE Oatfield Hill Rd

Clackamas

Oregon City APD

Capacity: 15

Administrator: Gita Reddy

Facility Phone: (503) 742-7218

Facility Fax: (503) 653-5705

Owner: Elite Care OE2, LLCCounty

Orig Lic. Date: 2014-04-25 Milwaukie, OR 97267

Renewal Date :2018-04-30 0

Units: 12

Management: Elite Care OE2, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R406

Elite Care Oatfield Estates Tabor House

4425 SE Oatfield Hill Rd

Clackamas

Oregon City

Capacity: 15

Administrator: Gita Reddy

Facility Phone: (503) 742-7218

Facility Fax: (503) 653-5705

Owner: Elite Care OE2 LLCCounty

Orig Lic. Date: 2014-04-25 Milwaukie, OR 97267

Renewal Date :2018-04-30 0

Units: 12

Management: Elite Care OE2, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R282

Elite Care Oatfield Estates-Adam's House

4483 SE Oatfield Hill Rd

Clackamas

Milwaukie SPD

Capacity: 15

Administrator: Douglas Edington

Facility Phone: (503) 513-4956

Facility Fax: (503) 513-4960

Owner: Elite Care Oatfield Estates, LLCCounty

Orig Lic. Date: 2001-08-10 Milwaukie, OR 97267

Renewal Date :2016-10-31 0

Units: 12

Management: Elite Care Management Group, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R330

Elite Care Oatfield Estates-Ashland House

4398 SE Oatfield Hill Rd.

Clackamas

Milwaukie SPD

Capacity: 15

Administrator: Gita Reddy

Facility Phone: (503) 758-0202

Facility Fax: (503) 785-0303

Owner: Elite Care Oatfield Estates, LLCCounty

Orig Lic. Date: 2004-09-15 Milwaukie, OR 97267

Renewal Date :2016-10-31 0

Units: 12

Management: Elite Care Management Group, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R289

Elite Care Oatfield Estates-Helen's House

4469 SE Oatfield Hill Rd.

Clackamas

Milwaukie SPD

Capacity: 15

Administrator: Douglas Edington

Facility Phone: (503) 653-5656

Facility Fax: (503) 653-5705

Owner: Elite Care Oatfield Estates, LLCCounty

Orig Lic. Date: 2001-10-22 Milwaukie, OR 97267

Renewal Date :2016-10-31 0

Units: 12

Management: Elite Care Management Group, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R256

Elite Care Oatfield Estates-Hood House

4499 SE Oatfield Hill Rd.

Clackamas

MilwauKie SPD

Capacity: 15

Administrator: Douglas Edington

Facility Phone: (503) 653-4853

Facility Fax: (503) 353-6624

Owner: Elite Care Oatfield Estates, LLCCounty

Orig Lic. Date: 2000-09-15 Milwaukie, OR 97267

Renewal Date :2016-10-31 0

Units: 12

Management: Elite Care Management Group, LLC

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 30 of 85

Page 31: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R318

Elite Care Oatfield Estates-Jefferson House

4422 SE Oatfield Hill Rd.

Clackamas

Milwaukie SPD

Capacity: 15

Administrator: Gita Reddy

Facility Phone: (503) 653-5656

Facility Fax: (503) 653-5705

Owner: Elite Care Oatfield Estates, LLCCounty

Orig Lic. Date: 2003-06-25 Milwaukie, OR 97267

Renewal Date :2016-10-31 0

Units: 12

Management: Elite Care Management Group, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R308

Elite Care Oatfield Estates-Rainier House

4457 SE Oatfield Hill Rd.

Clackamas

Milwaukie SPD

Capacity: 15

Administrator: Douglas Edington

Facility Phone: (503) 653-2104

Facility Fax: (503) 653-2105

Owner: Elite Care Oatfield Estates, LLCCounty

Orig Lic. Date: 2003-02-04 Milwaukie, OR 97267

Renewal Date :2016-10-31 0

Units: 12

Management: Elite Care Management Group, LLC

Non Medicaid

Email: [email protected]

Other Services:

50M144

Elizabethan Manor

44882 Mission Road

Umatilla

Pendleton

Capacity: 50

Administrator: Delores McLaren

Facility Phone: (541) 276-7157

Facility Fax: (541) 276-3093

Owner: Prestige Residential Community, L.L.CCounty

Orig Lic. Date: 1995-08-28 Pendleton, OR 97801

Renewal Date :2018-03-31 0

Units: 33

Management: Prestige Senior Living, L.L.C

Yes

Email: [email protected]

Other Services:

50M026

Ellendale Residential Care Center

511 E Ellendale Ave

Polk

Dallas NWSDS

Capacity: 34

Administrator: Arthur V Johnson

Facility Phone: (503) 623-3709

Facility Fax: (503) 623-7029

Owner: Dallas Care Center, Inc.County

Orig Lic. Date: 1972-01-01 Dallas, OR 97338

Renewal Date :2016-10-31 0

Units: 34

Management: Dallas Care Center, Inc.

Yes

Email: [email protected]

Other Services:

70M025

Elliott Residence

390 Church St

Marion

Salem NWSDS

Capacity: 60

Administrator: Mary Ziebert

Facility Phone: (503) 769-8313

Facility Fax: (503) 769-8318

Owner: Janmaur I, L.L.C.County

Orig Lic. Date: 1996-06-24 Sublimity, OR 97385

Renewal Date :2018-05-31 0

Units: 50

Management: Marian Estates Support Services

Yes

Email: [email protected]

Other Services:

50M019

Emerald Gardens

1890 N Newberg Hwy

Marion

Woodburn NWSDS

Capacity: 59

Administrator: Jessica Penland

Facility Phone: (503) 982-4000

Facility Fax: (503) 980-2049

Owner: RSL Woodburn, LLCCounty

Orig Lic. Date: 1987-10-01 Woodburn, OR 97071

Renewal Date :2017-05-31 0

Units: 44

Management: Radiant Senior Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 20

Tuesday, July 05, 2016 Page 31 of 85

Page 32: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M026

Emerald Valley Assisted Living

4550 W Amazon Dr

Lane

Eugene SSO

Capacity: 48

Administrator: Kristin Jensen

Facility Phone: (541) 345-9668

Facility Fax: (541) 345-1190

Owner: Cascade Living Group - Oregon, LLCCounty

Orig Lic. Date: 1990-08-15 Eugene, OR 97405

Renewal Date :2017-05-31 0

Units: 40

Management: Cascade Living Group, Inc.

Yes

Email: kristen.jensen@reveraliving,com

Other Services:

50R301

Emerson House

3577 SE Division

Multnomah

Portland SE ASO

Capacity: 55

Administrator: Erin Jones

Facility Phone: (503) 234-8585

Facility Fax: (503) 234-8535

Owner: Emerson House, LLCCounty

Orig Lic. Date: 2000-01-10 Portland, OR 97202

Renewal Date :2016-12-31 0

Units: 55

Management: Kinsel Ameri Properties, Inc.

Yes

Email: [email protected]

Other Services:

50R305

Evergreen Court of Molalla

250 Kennel St.

Clackamas

Canby SPD

Capacity: 52

Administrator: Lynn Gaffney

Facility Phone: (503) 829-2424

Facility Fax: (503) 829-2425

Owner: Molalla Senior Living, LLCCounty

Orig Lic. Date: 2002-10-25 Molalla, OR 97038

Renewal Date :2017-10-31 0

Units: 34

Management: Avant Senior Housing Managers & Consultants,

Yes

Email: [email protected]

Other Services: MCC, ACU 27

50A219

Expressions at Summerplace

15727 NE Russell Street

Multnomah

Mid-County ASD

Capacity: 20

Administrator: Shannon Robb

Facility Phone: (503) 252-9361

Facility Fax: (503) 252-9405

Owner: Summerplace Assisted Living, LLCCounty

Orig Lic. Date: 1999-07-31 Portland, OR 97230

Renewal Date :2017-07-31 0

Units: 16

Management: Prestige Senior Living, L.L.C

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 20

50R340

Fanno Creek by Elite Care

12353 SW Grant St

Washington

WCDAVS

Capacity: 30

Administrator: Laurie Laverdiere

Facility Phone: (971) 506-2359

Facility Fax: (503) 653-5705

Owner: Elite Care Grant, LLCCounty

Orig Lic. Date: 2008-05-09 Tigard, OR 97223

Renewal Date :2018-04-30 0

Units: 30

Management: Elite Care Management Group, LLC

Non Medicaid

Email: [email protected]

Other Services:

50A028

Farmington Square - Beaverton

14420 SW Farmington Rd

Washington

WCDAVS

Capacity: 70

Administrator: Teddi Neilson

Facility Phone: (503) 626-2273

Facility Fax: (503) 627-0262

Owner: RSL Beaverton, LLCCounty

Orig Lic. Date: 1993-05-10 Beaverton, OR 97005

Renewal Date :2017-07-31 0

Units: 59

Management: Radiant Senior Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 44

Tuesday, July 05, 2016 Page 32 of 85

Page 33: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50A149

Farmington Square - Eugene

2730 Bailey Lane

Lane

Eugene AAA

Capacity: 66

Administrator: Billie Wingfield

Facility Phone: (541) 344-7902

Facility Fax: (541) 344-5627

Owner: RSL Eugene, LLCCounty

Orig Lic. Date: 1996-06-30 Eugene, OR 97401

Renewal Date :2015-07-31 0

Units: 66

Management: Radiant Senior Living, Inc.

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 24

5MA031

Farmington Square - Gresham

1655 NE 18th

Multnomah

Mid-County ASD

Capacity: 76

Administrator: Betty Aberg

Facility Phone: (503) 665-1994

Facility Fax: (503) 492-2172

Owner: RSL Gresham, LLCCounty

Orig Lic. Date: 1992-06-01 Gresham, OR 97030

Renewal Date :2017-07-31 0

Units: 64

Management: Radiant Senior Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 38

50A083

Farmington Square - Medford

1530 Poplar Dr

Jackson

Medford AAA

Capacity: 81

Administrator: Darren Penquite

Facility Phone: (541) 770-9080

Facility Fax: (541) 857-0272

Owner: RSL Medford, LLCCounty

Orig Lic. Date: 1994-01-31 Medford, OR 97504

Renewal Date :2016-09-30 0

Units: 52

Management: Radiant Senior Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 81

50A034

Farmington Square - Salem

910 Boone Rd SE

Marion

Salem NWSDS

Capacity: 122

Administrator: Margo Garibay

Facility Phone: (503) 363-2273

Facility Fax: (503) 363-4991

Owner: RSL Salem, LLCCounty

Orig Lic. Date: 1994-08-24 Salem, OR 97306

Renewal Date :2017-07-31 0

Units: 102

Management: Radiant Senior Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 70

50A143

Farmington Square - Tualatin

17950 SW 115th Ave

Washington

WCDAVS

Capacity: 64

Administrator: Steven Worral

Facility Phone: (503) 692-1748

Facility Fax: (503) 691-2759

Owner: RSL Tualatin, LLCCounty

Orig Lic. Date: 1995-08-28 Tualatin, OR 97062

Renewal Date :2017-07-31 0

Units: 60

Management: Radiant Senior Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 46

50R379

Fern Gardens Memory Care

2636 Table Rock Rd

Jackson

Medford SSO

Capacity: 84

Administrator: Tish Cofer

Facility Phone: (541) 779-3368

Facility Fax: (541) 773-5724

Owner: Fern Gardens Memory Care, LLCCounty

Orig Lic. Date: 2011-08-26 Medford, OR 97504

Renewal Date :2017-08-31 0

Units: 44

Management: Ridgeline Management Co.

Yes

Email: [email protected]

Other Services: MCC, ACU 84

Tuesday, July 05, 2016 Page 33 of 85

Page 34: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A311

Fircrest Community Living

213 NE Fircrest Drive

Yamhill

McMinnville NWSDS

Capacity: 29

Administrator: Amanda Killinger

Facility Phone: (503) 472-2200

Facility Fax: (503) 883-9462

Owner: Fircrest Community Living, Inc.County

Orig Lic. Date: 2009-04-01 McMinnville, OR 97128

Renewal Date :2017-04-30 0

Units: 29

Management: Fircrest Community Living, Inc.

Yes

Email: [email protected]

Other Services:

50R358

Fircrest Memory Care

213 NE Fircrest Drive

Yamhill

McMinnville NWSDS

Capacity: 52

Administrator: Elisabeth Williams

Facility Phone: (503) 472-2200

Facility Fax: (503) 883-9462

Owner: Fircrest Community Living, Inc.County

Orig Lic. Date: 2009-04-01 McMinnville, OR 97128

Renewal Date :2017-04-30 0

Units: 52

Management: Fircrest Community Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 52

50M037

Firwood Gardens RCF

819 NE 122nd Ave

Multnomah

E County ASD

Capacity: 85

Administrator: Nikki Bales

Facility Phone: (503) 252-0086

Facility Fax: (503) 252-2327

Owner: Sapphire at Firwood, LLCCounty

Orig Lic. Date: 1980-12-01 Portland, OR 97230

Renewal Date :2017-11-30 0

Units: 78

Management: Sapphire at Firwood, LLC

Yes

Email: [email protected]

Other Services:

70M028

Flagstone Retirement & Assisted Living

3325 Columbia View Dr.

Wasco

Mid-Columbia AAA

Capacity: 60

Administrator: Sharla Mosqueda

Facility Phone: (541) 298-5656

Facility Fax: (541) 298-1685

Owner: Flagstone Operations, LLC.County

Orig Lic. Date: 1992-02-15 The Dalles, OR 97058

Renewal Date :2016-10-31 0

Units: 50

Management: Milestone Retirement Communities, LLC

Yes

Email: [email protected]

Other Services:

50R398

Footsteps at Carman Oaks

3900 SW Carman Drive

Washington

Milwaukie APD

Capacity: 16

Administrator: Martina Padron

Facility Phone: (503) 636-4700

Facility Fax:

Owner: HSRE-Springs II at Lake Oswego Sub-TRS, LLCCounty

Orig Lic. Date: 2013-09-04 Lake Oswego, OR 97035

Renewal Date :2017-09-30 0

Units: 12

Management: The Springs Living, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 16

50R377

Footsteps at Clackamas Woods

14314 SE Webster Road

Clackamas

Milwaukie SPD

Capacity: 32

Administrator: Jennifer McClure

Facility Phone: (503) 654-3413

Facility Fax: (503) 653-3425

Owner: TSL Clack OPS, LLCCounty

Orig Lic. Date: 2011-06-01 Milwaukie, OR 97267

Renewal Date :2016-10-31 0

Units: 24

Management: The Springs Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 32

Tuesday, July 05, 2016 Page 34 of 85

Page 35: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R399

Footsteps at Mill Creek

1021 W 10th Street

Wasco

The Dalles ADS

Capacity: 25

Administrator: Naomi Ma'ae

Facility Phone: (541) 296-1303

Facility Fax:

Owner: HSRE-Springs II at the Dalles, LLPCounty

Orig Lic. Date: 2013-10-09 The Dalles, OR 97058

Renewal Date :2017-10-31 0

Units: 19

Management: The Springs Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 25

50R397

Footsteps at Sherwood

15677 SW Oregon

Washington

Tigard APD

Capacity: 31

Administrator: Angela Jones

Facility Phone: (503) 625-9481

Facility Fax: (503) 625-1372

Owner: HSRE-Springs II at Sherwood Sub-TRS, LLCCounty

Orig Lic. Date: 2013-09-04 Sherwood, OR 97140

Renewal Date :2017-09-30 0

Units: 21

Management: The Springs Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 21

50R361

Footsteps at Tanasbourne

1950 NW 192nd Avenue

Washington

Hillsboro WCDAVS

Capacity: 12

Administrator: Leanne Barger

Facility Phone: (503) 629-5500

Facility Fax: (503) 629-1515

Owner: Springs at Tanasbourne II, LLCCounty

Orig Lic. Date: 2009-08-01 Hillsboro, OR 97006

Renewal Date :2016-12-31 0

Units: 12

Management: The Springs Living, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 12

5MA217

Footsteps at The Wilsonville

7600 Vlahos Drive

Clackamas

Canby SPD

Capacity: 51

Administrator: Vanessa Ceryance

Facility Phone: (503) 582-9414

Facility Fax: (503) 582-9236

Owner: HSRE-Springs at Wilsonville Sub-TRS, LLCCounty

Orig Lic. Date: 1999-06-24 Wilsonville, OR 97070

Renewal Date :2016-11-30 0

Units: 51

Management: The Springs Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 51

50M209

Forest Glen Senior Residence

200 SW Frontage Rd.

Douglas

Roseburg AAA

Capacity: 36

Administrator: Louise Cousins

Facility Phone: (541) 839-4266

Facility Fax: (541) 839-4857

Owner: Aspen FoundationCounty

Orig Lic. Date: 1993-09-01 Canyonville, OR 97417

Renewal Date :2016-11-30 0

Units: 19

Management: Aspen Foundation

Yes

Email: [email protected]

Other Services:

70M029

Forest Grove Beehive

2122 Hawthorne

Washington

WCDAVS

Capacity: 48

Administrator: Elizabeth Alter

Facility Phone: (503) 357-6409

Facility Fax: (503) 357-9046

Owner: Forest Grove Beehive, LLCCounty

Orig Lic. Date: 1991-08-28 Forest Grove, OR 97116

Renewal Date :2017-08-31 0

Units: 44

Management: Caring Places Management, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 35 of 85

Page 36: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50M154

Forest Meadows RCF

625 Barbara Dr

Josephine

Grants Pass MSO

Capacity: 15

Administrator: Blake Gowans

Facility Phone: (541) 479-8865

Facility Fax: (541) 955-9820

Owner: Forest Meadows RCF, Inc.County

Orig Lic. Date: 1997-01-16 Grants Pass, OR 97526

Renewal Date :2016-08-31 0

Units: 15

Management: Forest Meadows RCF, Inc.

Yes

Email: [email protected]

Other Services:

50R038

Fountain Plaza

1441 Morrow Rd

Jackson

Medford SSO

Capacity: 19

Administrator: Charmagne Manlulu

Facility Phone: (541) 772-6005

Facility Fax: (541) 734-5000

Owner: Fountain Plaza, L.L.C.County

Orig Lic. Date: 1991-06-01 Medford, OR 97504

Renewal Date :2017-12-31 0

Units: 19

Management: Dharma Healthcare Management, Inc.

Non Medicaid

Email: [email protected]

Other Services:

70M094

Fountains At Town Center Village, The

8607 SE Causey Ave

Clackamas

Milwaukie SPD

Capacity: 87

Administrator: Steven Esser

Facility Phone: (503) 654-4500

Facility Fax: (503) 786-1232

Owner: TCV Employees, LLCCounty

Orig Lic. Date: 1991-02-01 Happy Valley, OR 97086

Renewal Date :2017-05-31 0

Units: 77

Management: Generations, LLC

Yes

Email: [email protected]

Other Services:

50M268

Four Seasons RCF - Fairgrounds

2850 Evergreen Ave NE

Marion

Salem NWSDS

Capacity: 32

Administrator: Jane Albert

Facility Phone: (503) 566-5876

Facility Fax: (503) 588-7125

Owner: Four Seasons RCF FairgroundsCounty

Orig Lic. Date: 2001-03-15 Salem, OR 97303

Renewal Date :2017-07-31 0

Units: 26

Management: Four Seasons RCF Fairgrounds

Yes

Email: [email protected]

Other Services:

50R395

Four Seasons RCF Evergreen

2855 Evergreen Ave NE

Marion

Salem NWSDS

Capacity: 28

Administrator: Kathy Mauch

Facility Phone: (503) 999-1135

Facility Fax: (503) 371-7355

Owner: Four Seasons RCF EvergreenCounty

Orig Lic. Date: 2013-08-15 Salem, OR 97301

Renewal Date :2017-08-31 0

Units: 28

Management: Four Seasons RCF Evergreen

Yes

Email: [email protected]

Other Services:

70A294

Fox Hollow Independent & Assisted Living Community

2599 NE Studio Rd

Deschutes

Bend SPD

Capacity: 76

Administrator: Erin Crow

Facility Phone: (541) 383-2030

Facility Fax: (541) 383-4979

Owner: Fox Hollow Bend, LLCCounty

Orig Lic. Date: 2005-02-23 Bend, OR 97701

Renewal Date :2018-04-30 0

Units: 71

Management: Regency Pacific Management, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 36 of 85

Page 37: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R046

Fox Hollow Residential Care Community

5320 Fox Hollow Rd

Lane

Eugene SSO

Capacity: 54

Administrator: Janet Engel

Facility Phone: (541) 343-8439

Facility Fax: (541) 683-9427

Owner: Regency At Fox Hollow, Inc.County

Orig Lic. Date: 1988-01-01 Eugene, OR 97405

Renewal Date :2016-07-31 0

Units: 51

Management: Prestige Care Inc.

Non Medicaid

Email: [email protected]

Other Services:

50R040

Friendsview Retirement Community

1301 E Fulton St

Yamhill

McMinnville NWSDS

Capacity: 155

Administrator: Kim Libonati

Facility Phone: (503) 538-3144

Facility Fax: (503) 538-6371

Owner: Friendsview Manor, Inc.County

Orig Lic. Date: 1993-10-26 Newberg, OR 97132

Renewal Date :2016-08-31 0

Units: 89

Management: Friendsview Manor, Inc.

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 18

70M063

Gardens at Laurelhurst Village, The

3060 SE Stark St

Multnomah

SE Portland ASO

Capacity: 25

Administrator: Christine M Madewell

Facility Phone: (503) 535-4932

Facility Fax: (503) 535-4951

Owner: Laurelhurst Operations, LLCCounty

Orig Lic. Date: 1997-09-04 Portland, OR 97214

Renewal Date :2017-06-30 0

Units: 25

Management: Laurelhurst Operations, LLC

Yes

Email: [email protected]

Other Services:

5MA242

Gardens Enhanced Care Community, The

3334 22nd Ave

Washington

WCDAVS

Capacity: 56

Administrator: Luan O'Daniels

Facility Phone: (503) 357-9780

Facility Fax: (503) 357-6996

Owner: The Grove Assisted Living, L.L.C.County

Orig Lic. Date: 2000-04-07 Forest Grove, OR 97116

Renewal Date :2017-08-31 0

Units: 28

Management: Heights Management, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 56

50R311

Gardens, The

2690 NE Yacht

Lincoln

Toledo/Lincoln SSO

Capacity: 43

Administrator: Tiffany Helton

Facility Phone: (541) 994-7400

Facility Fax: (541) 994-5678

Owner: Lakeview Operations, LLCCounty

Orig Lic. Date: 2003-03-21 Lincoln City, OR 97367

Renewal Date :2016-09-30 0

Units: 31

Management: Westmont Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 43

50R388

Gateway 2 Healthier Living

608 N Cloverleaf Loop

Lane

Eugene

Capacity: 10

Administrator: Mark Kinkade

Facility Phone: (541) 744-9817

Facility Fax: (541) 744-0220

Owner: Gateway Assisted Living, IncCounty

Orig Lic. Date: 2013-03-05 Springfield, OR 97477

Renewal Date :2017-03-31 0

Units: 10

Management: Gateway Assisted Living, Inc.

Yes

Email: [email protected]

Other Services: ECU 10

Tuesday, July 05, 2016 Page 37 of 85

Page 38: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R304

Gateway Gardens

178 Commons Dr.

Lane

Eugene AAA

Capacity: 90

Administrator: Sherri Borth

Facility Phone: (541) 302-1283

Facility Fax: (541) 485-8978

Owner: Gateway Gardens Assisted Living, Inc.County

Orig Lic. Date: 2002-11-01 Eugene, OR 97401

Renewal Date :2017-11-30 0

Units: 78

Management: Gateway Gardens Assisted Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 75

5MA042

Gateway Living

611 N Cloverleaf Loop

Lane

Eugene

Capacity: 130

Administrator: Jessica Knox

Facility Phone: (541) 744-9817

Facility Fax: (541) 744-0220

Owner: Gateway Assisted Living, IncCounty

Orig Lic. Date: 1991-02-01 Springfield, OR 97477

Renewal Date :2017-04-30 0

Units: 118

Management: Gateway Assisted Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 70

70M030

Gibson Creek Retirement & Assisted Living Residence

1615 Brush College Rd NW

Polk

Salem NWSDS

Capacity: 65

Administrator: Sandra Abt

Facility Phone: (503) 361-8599

Facility Fax: (503) 371-1160

Owner: TLC West, L.L.C.County

Orig Lic. Date: 1997-09-30 Salem, OR 97304

Renewal Date :2017-09-30 0

Units: 50

Management: Bonaventure Senior Living

Yes

Email: [email protected]

Other Services:

70M031

Gilman Park Assisted Living

2205 Gilman Drive

Clackamas

Milwaukie SPD

Capacity: 101

Administrator: Nathan Emge

Facility Phone: (503) 657-5700

Facility Fax: (503) 657-1183

Owner: FM Gilman, LLCCounty

Orig Lic. Date: 1995-02-01 Oregon City, OR 97045

Renewal Date :2017-01-31 0

Units: 101

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

50M044

Golden Acres Retirement Center

12711 SE Holgate Blvd

Multnomah

East County ASD

Capacity: 50

Administrator: Sandi Tidwell

Facility Phone: (503) 761-6421

Facility Fax: (503) 762-2423

Owner: Sandra TidwellCounty

Orig Lic. Date: 1960-01-01 Portland, OR 97236

Renewal Date :2016-08-31 0

Units: 32

Management: Sandra Tidwell

Yes

Email: [email protected]

Other Services:

50R319

Golden Age Living, LLC

3484 SE Hill Rd.

Clackamas

Milwaukie Spd

Capacity: 15

Administrator: Persida Stana

Facility Phone: (503) 652-8000

Facility Fax: (503) 652-8902

Owner: Golden Age Living LLCCounty

Orig Lic. Date: 2003-07-17 Milwaukie, OR 97267

Renewal Date :2018-04-30 0

Units: 12

Management: Golden Age Living LLC

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 38 of 85

Page 39: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R402

Grace Manor Residential Care

2811 Bailey Lane

Lane

Eugene APD

Capacity: 18

Administrator: Daniel Vlaciu

Facility Phone: (541) 686-2721

Facility Fax: (541) 338-9003

Owner: Grace Manor Lease Interests, LLCounty

Orig Lic. Date: 2014-03-14 Eugene, OR 97401

Renewal Date :2018-03-31 0

Units: 18

Management: Senior Housing Managers, LLC

Yes

Email: [email protected]

Other Services:

70M032

Grace Place

380 NW 6th Ave

Clackamas

Estacada SPD

Capacity: 36

Administrator: Luke Wilkenfeldt

Facility Phone: (503) 630-5341

Facility Fax: (503) 630-5348

Owner: GRACE AID OPCO, LLCCounty

Orig Lic. Date: 1997-01-08 Estacada, OR 97023

Renewal Date :2017-07-31 0

Units: 30

Management: GRACE AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

70M033

Grande Ronde Retirement Residence

1809 Gekeler Lane

Union

La Grande MSO

Capacity: 76

Administrator: Mark Stephenson

Facility Phone: (541) 963-4700

Facility Fax: (541) 963-6519

Owner: FM Grande, LLCCounty

Orig Lic. Date: 1990-07-01 La Grande, OR 97850

Renewal Date :2017-01-31 0

Units: 66

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

70M034

Greenridge Estates At Mountain Park, LLC.

4 Greenridge Dr

Clackamas

Milwaukie SPD

Capacity: 79

Administrator: Rebecca Rhineheimer

Facility Phone: (503) 635-8818

Facility Fax: (503) 635-6857

Owner: Greenridge Estates at Mountain Park, LLCCounty

Orig Lic. Date: 1992-06-03 Lake Oswego, OR 97035

Renewal Date :2018-05-31 0

Units: 71

Management: Greenridge Estates at Mountain Park, LLC

Yes

Email: [email protected]

Other Services:

50R387

Griffin House, The

6630 Alderbrook Road

Tillamook

Tillamook NWSDS

Capacity: 13

Administrator: Sharon Griffin

Facility Phone: (503) 801-0418

Facility Fax:

Owner: The Griffin House LLCCounty

Orig Lic. Date: 2012-10-25 Tillamook, OR 97141

Renewal Date :2016-10-31 0

Units: 12

Management: The Griffin House LLC

Yes

Email: [email protected]

Other Services:

70M035

Grove Assisted Living, The

2112 Oak St

Washington

WCDAVS

Capacity: 78

Administrator: Thomas O'Daniels

Facility Phone: (503) 359-1002

Facility Fax: (503) 359-0615

Owner: The Grove Assisted Living, L.L.C.County

Orig Lic. Date: 1996-08-01 Forest Grove, OR 97116

Renewal Date :2017-08-31 0

Units: 63

Management: Heights Management, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 39 of 85

Page 40: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M079

Guardian Angel Homes

540 NW 12th St

Umatilla

Hermiston MSO

Capacity: 40

Administrator: Leslie Wolf

Facility Phone: (541) 564-9070

Facility Fax: (541) 564-8178

Owner: Hermiston Health Care, LLCCounty

Orig Lic. Date: 1995-09-07 Hermiston, OR 97838

Renewal Date :2017-06-30 0

Units: 32

Management: Tailored Management Services, LLC

Yes

Email: [email protected]

Other Services:

50M428

Guardian Angel Homes Memory Care

540 N.W. 12th Street

Umatilla

Hermiston

Capacity: 16

Administrator: Angela Turner

Facility Phone: (541) 564-9070

Facility Fax: (541) 567-6421

Owner: Hermiston Health Care, LLCCounty

Orig Lic. Date: 2016-04-25 Hermiston, OR 97838

Renewal Date :2018-04-30 0

Units: 16

Management: Tailored Management Services, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 16

50M124

Harmony Estates Residential Care Center

87326 McTimmons Lane

Coos

Coos Bay MSO

Capacity: 30

Administrator: Michael Schulz

Facility Phone: (541) 347-9631

Facility Fax: (541) 347-9631

Owner: Harmony Estates, Inc.County

Orig Lic. Date: 1985-01-09 Bandon, OR 97411

Renewal Date :2016-05-31 0

Units: 30

Management: Harmony Estates, Inc.

Yes

Email: [email protected]

Other Services:

50M049

Harmony Guest Home

351 SE Fifth St

Washington

Hillsboro

Capacity: 62

Administrator: Lucy Gallarde

Facility Phone: (503) 648-3413

Facility Fax: (503) 693-6695

Owner: Harmony Guest Home, Inc.County

Orig Lic. Date: 1990-05-01 Hillsboro, OR 97123

Renewal Date :2017-05-31 0

Units: 42

Management: Harmony Guest Home, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 32

50R356

Harmony House of Salem

3062 Hyacinth St. NE

Marion

Salem NWSDS

Capacity: 15

Administrator: Michele Nixon

Facility Phone: (503) 588-0722

Facility Fax: (503) 588-0755

Owner: Pacific Living Centers, Inc.County

Orig Lic. Date: 2009-01-16 Salem, OR 97301

Renewal Date :2017-01-31 0

Units: 15

Management: Pacific Living Centers, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 15

5ME248

Harmony Living

1535 SW Shirley Ann Drive

Yamhill

McMinnville NWSDS

Capacity: 16

Administrator: Dagny Sprayberry

Facility Phone: (503) 472-9997

Facility Fax: (503) 472-9986

Owner: Harmony Living, Inc.County

Orig Lic. Date: 2000-05-15 McMinnville, OR 97128

Renewal Date :2016-05-31 0

Units: 9

Management: Harmony Living, Inc.

Yes

Email: [email protected]

Other Services: ECU 16

Tuesday, July 05, 2016 Page 40 of 85

Page 41: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

5MA051

Harvest Homes RCF

6921 N Roberts

Multnomah

NE Portland ASO/DSO

Capacity: 40

Administrator: Kelly Chancellor

Facility Phone: (503) 286-2423

Facility Fax: (503) 286-1110

Owner: Harvest Homes, Inc.County

Orig Lic. Date: 1971-01-01 Portland, OR 97203

Renewal Date :2018-02-28 0

Units: 39

Management: Harvest Homes, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 20

70M036

Harvest Homes, Inc.

6921 N Roberts Ave

Multnomah

NE Portland ASO/DSO

Capacity: 49

Administrator: Jeanine Sinnott

Facility Phone: (503) 286-2423

Facility Fax: (503) 289-6473

Owner: Harvest Homes, Inc.County

Orig Lic. Date: 1998-05-29 Portland, OR 97203

Renewal Date :2018-05-31 0

Units: 42

Management: Harvest Homes, Inc.

Yes

Email: [email protected]

Other Services:

50M201

Haven House Retirement Center

714 Main Street PO Bos 386

Wheeler

The Dalles AAA

Capacity: 19

Administrator: Marjorie Sharp

Facility Phone: (541) 763-4651

Facility Fax: (541) 763-2129

Owner: Fossil Elderly Housing Committee, Inc.County

Orig Lic. Date: 1999-07-01 Fossil, OR 97830

Renewal Date :2017-07-31 0

Units: 19

Management: Fossil Elderly Housing Committee, Inc.

Yes

Email: [email protected]

Other Services:

70A269

Hawks Ridge Senior Assisted Living Community

1795 8th St

Hood River

The Dalles MSO

Capacity: 85

Administrator: Heather Lilly

Facility Phone: (541) 387-4087

Facility Fax: (541) 387-2697

Owner: LSREF Golden Ops 26 (OR) LLCCounty

Orig Lic. Date: 2001-10-19 Hood River, OR 97031

Renewal Date :2017-01-31 0

Units: 70

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

50R350

Hawthorne Gardens Memory Care Community

2828 SE Taylor Street

Multnomah

E Cty ASD

Capacity: 21

Administrator: Emily Taghon

Facility Phone: (971) 222-0396

Facility Fax: (971) 222-0397

Owner: GF Hawthorne Tenant, LLCCounty

Orig Lic. Date: 2007-07-30 Portland, OR 97214

Renewal Date :2017-09-30 0

Units: 12

Management: Artegan at Hawthorne Gardens, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 21

70A309

Hawthorne Gardens Senior Living Community

2828 SE Taylor Street

Multnomah

E Cty ASD

Capacity: 65

Administrator: Tawnia Boehmer

Facility Phone: (971) 222-0396

Facility Fax: (971) 222-0397

Owner: GF Hawthorne Tenant, LLCCounty

Orig Lic. Date: 2007-07-30 Portland, OR 97214

Renewal Date :2017-09-30 0

Units: 46

Management: Artegan at Hawthorne Gardens, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 41 of 85

Page 42: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R376

Hawthorne House

2635 21st Avenue

Washington

Hillsboro SPD

Capacity: 22

Administrator: Kathleen Leatham

Facility Phone: (503) 357-6409

Facility Fax: (503) 357-9046

Owner: Hawthorne House, LLCCounty

Orig Lic. Date: 2011-05-26 Forest Grove, OR 97116

Renewal Date :2017-05-31 0

Units: 22

Management: Caring Places Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 22

50R300

Hawthorne House of Salem

3042 Hyacinth St. NE

Marion

Salem NWSDS

Capacity: 15

Administrator: Krishanna Jaramillo

Facility Phone: (503) 763-2722

Facility Fax: (503) 763-2677

Owner: Pacific Living Centers, Inc.County

Orig Lic. Date: 2002-08-30 Salem, OR 97303

Renewal Date :2016-08-31 0

Units: 11

Management: Pacific Living Centers, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 15

50R294

Hearthstone at Murrayhill

10880 SW Davies Rd.

Washington

Hillsboro WCDAVS

Capacity: 142

Administrator: Tom Freitag

Facility Phone: (503) 520-0911

Facility Fax: (503) 641-4944

Owner: Hearthstone at Murrayhill, LLCCounty

Orig Lic. Date: 2002-02-28 Beaverton, OR 97008

Renewal Date :2018-02-28 0

Units: 119

Management: Hearthstone Management Services, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 32

70A273

Hearthstone at Murrayhill Assisted Living

10880 SW Davies Rd

Washington

Hillsboro WCDAVS

Capacity: 80

Administrator: Tom Freitag

Facility Phone: (503) 520-0911

Facility Fax: (503) 641-4944

Owner: Hearthstone at Murrayhill, LLCCounty

Orig Lic. Date: 2002-02-28 Beaverton, OR 97008

Renewal Date :2018-02-28 0

Units: 64

Management: Hearthstone Management Services, LLC

Non Medicaid

Email: [email protected]

Other Services:

70M037

Hearthstone Of Beaverton

12520 SW Hart Rd

Washington

WCDAVS

Capacity: 75

Administrator: Duane Miner

Facility Phone: (503) 641-0911

Facility Fax: (503) 641-1118

Owner: Hearthstone of Beaverton Operations, LLCCounty

Orig Lic. Date: 1996-11-01 Beaverton, OR 97008

Renewal Date :2016-10-31 0

Units: 58

Management: Hearthstone Management Services, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R409

Heartwood Place

2325 Boones Ferry Road

Marion

woodburn NWSDS

Capacity: 48

Administrator: Lorri Marcott

Facility Phone: (503) 980-9990

Facility Fax: (503) 980-9995

Owner: WMC Operating Company LLCCounty

Orig Lic. Date: 2014-05-02 Woodburn, OR 97071

Renewal Date :2018-05-31 0

Units: 48

Management: Benicia Senior Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 48

Tuesday, July 05, 2016 Page 42 of 85

Page 43: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R332

Heritage House of Woodburn

943 N. Cascade Dr.

Marion

Woodburn NWSDS

Capacity: 15

Administrator: Shannon Souza

Facility Phone: (503) 982-1506

Facility Fax: (503) 982-1175

Owner: Pacific Living Centers, Inc.County

Orig Lic. Date: 2004-12-15 Woodburn, OR 97071

Renewal Date :2016-12-31 0

Units: 15

Management: Pacific Living Centers, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 15

70M241

High Lookee Lodge

2321 Ollallie Lane PO Box 6

Jefferson

Madras MSO

Capacity: 53

Administrator: Jolene Switzler

Facility Phone: (541) 553-1182

Facility Fax: (541) 553-1186

Owner: Confederated Tribes of Warm Springs Reservation ofCounty

Orig Lic. Date: 2000-04-17 Warm Springs, OR 97761

Renewal Date :2015-10-31 0

Units: 36

Management: Confederated Tribes of Warm Springs Reservat

Yes

Email: [email protected]

Other Services:

50M211

Hill House

1325 SW Gibbs Street

Multnomah

WCDAVS

Capacity: 28

Administrator: Sharleen Moschella

Facility Phone: (503) 274-0000

Facility Fax: (503) 243-3427

Owner: Peaks and Valleys, LLCCounty

Orig Lic. Date: 1998-05-28 Portland, OR 97239

Renewal Date :2017-08-31 0

Units: 20

Management: Peaks and Valleys, LLC

Yes

Email: [email protected]

Other Services:

50R369

Hillside Care Manor

800 NW 25th Avenue

Multnomah

West ADS

Capacity: 40

Administrator: Alma Navarro

Facility Phone: (503) 688-5080

Facility Fax: (503) 688-5096

Owner: Peaks and Valleys, LLCCounty

Orig Lic. Date: 2010-07-16 Portland, OR 97210

Renewal Date :2017-10-31 0

Units: 24

Management: Peaks and Valleys, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 25

70M041

Hillside Place

1400 SE 19th

Lincoln

Toledo/Lincoln SSO

Capacity: 37

Administrator: Jill Woolsey

Facility Phone: (541) 994-8028

Facility Fax: (541) 994-8331

Owner: HILLSIDE AID OPCO, LLCCounty

Orig Lic. Date: 1992-07-08 Lincoln City, OR 97367

Renewal Date :2017-07-31 0

Units: 33

Management: HiLLSIDE AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R230

Holladay Park Plaza

1300 NE 16th

Multnomah

NE Portland ASO/DSO

Capacity: 44

Administrator: Tia Dodge

Facility Phone: (503) 288-6671

Facility Fax: (503) 331-4853

Owner: Holladay Park Plaza, Inc.County

Orig Lic. Date: 2000-01-06 Portland, OR 97232

Renewal Date :2016-12-31 0

Units: 35

Management: Pacific Retirement Services, Inc.

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 43 of 85

Page 44: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50A074

Holly Residential Care Center

1075 Irvington Drive

Lane

Eugene AAA

Capacity: 42

Administrator: Jeffrey Laramee

Facility Phone: (541) 607-8587

Facility Fax: (541) 607-8595

Owner: The Maren CorporationCounty

Orig Lic. Date: 1999-10-15 Eugene, OR 97404

Renewal Date :2017-05-31 0

Units: 38

Management: The Maren Corporation

Yes

Email: [email protected]

Other Services:

70M042

Homewood Heights Assisted Living

17999 SE River Rd

Clackamas

Milwaukie SPD

Capacity: 52

Administrator: Linda Nickolisen

Facility Phone: (503) 659-6600

Facility Fax: (503) 659-8193

Owner: Homewoods Heights LLCCounty

Orig Lic. Date: 1996-03-01 Milwaukie, OR 97267

Renewal Date :2018-02-28 0

Units: 44

Management: Prestige Senior Living, L.L.C

Yes

Email: [email protected]

Other Services:

50R316

Hope N Care

12045 SE Pardee St.

Multnomah

Mid-Mult ASD

Capacity: 64

Administrator: Rosalinda Asa

Facility Phone: (503) 761-6939

Facility Fax: (503) 761-5909

Owner: Asa Care, Inc.County

Orig Lic. Date: 2003-04-25 Portland, OR 97266

Renewal Date :2017-04-30 0

Units: 64

Management: Asa Care, Inc.

Yes

Email: [email protected]

Other Services:

50R145

Horton Plaza

1122 Spring St

Jackson

Medford AAA

Capacity: 17

Administrator: Danielle Stovall

Facility Phone: (541) 770-1122

Facility Fax: (541) 770-9576

Owner: Horton Plaza A Joint VentureCounty

Orig Lic. Date: 1995-08-14 Medford, OR 97504

Renewal Date :2017-08-31 0

Units: 16

Management: Dharma Healthcare Management, Inc.

Non Medicaid

Email: [email protected]

Other Services:

50R062

Hubbard Residential Care Facility

647 Junction Rd

Douglas

Roseburg AAA

Capacity: 7

Administrator: Ann Hubbard

Facility Phone: (541) 832-3282

Facility Fax: (541) 832-2676

Owner: Norma Ann HubbardCounty

Orig Lic. Date: 1972-11-01 Glendale, OR 97442

Renewal Date :2017-08-31 0

Units: 7

Management: Norma Ann Hubbard

Yes

Email: [email protected]

Other Services:

70M044

Inland Point Retirement Community

2290 Inland Dr

Coos

Coos Bay MSO

Capacity: 60

Administrator: Susan Cain

Facility Phone: (541) 756-0176

Facility Fax: (541) 756-8405

Owner: Cascade Living Group - Oregon, LLCCounty

Orig Lic. Date: 1995-11-22 North Bend, OR 97459

Renewal Date :2017-05-31 0

Units: 50

Management: Cascade Living Group, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 44 of 85

Page 45: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R251

Ivy Court Senior Living

18265 SE River Road

Clackamas

Milwaukie SPD

Capacity: 16

Administrator: Margaret Oliver

Facility Phone: (503) 786-3443

Facility Fax: (503) 786-9650

Owner: Ivy Court Senior Living, Inc.County

Orig Lic. Date: 2000-08-15 Milwaukie, OR 97222

Renewal Date :2016-08-31 0

Units: 16

Management: Ivy Court Senior Living, Inc.

Non Medicaid

Email: [email protected]

Other Services:

50M065

Jefferson Lodge Memory Care Community

664 SE Jefferson St

Polk

Dallas NWSDS

Capacity: 50

Administrator: Margaret Schreiber-Wise

Facility Phone: (503) 623-8104

Facility Fax: (503) 588-8653

Owner: Cascade Living Group - Oregon, LLCCounty

Orig Lic. Date: 1994-07-18 Dallas, OR 97338

Renewal Date :2017-05-31 0

Units: 44

Management: Cascade Living Group, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 50

70A214

Jennings - McCall Center

2300 Masonic Way

Washington

WCDAVS

Capacity: 147

Administrator: Jennifer Buckhannon

Facility Phone: (503) 359-4465

Facility Fax: (503) 359-4468

Owner: Grand Lodge of AF & AM of OregonCounty

Orig Lic. Date: 1991-12-12 Forest Grove, OR 97116

Renewal Date :2017-11-30 0

Units: 121

Management: Aidan Health Services, Inc.

Yes

Email: [email protected]

Other Services:

50R393

Jennings McCall RCF

2300 Masonic Way

Washington

WCDAVS

Capacity: 27

Administrator: Keirsten Holm

Facility Phone: (503) 359-4465

Facility Fax: (503) 359-8552

Owner: Grand Lodge of AF & AM of OregonCounty

Orig Lic. Date: 2013-06-18 Forest Grove, OR 97116

Renewal Date :2017-06-30 0

Units: 27

Management: Aidan Health Services, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 27

70M048

Junction City Retirement & Assisted Living Residence

500 E 6th St

Lane

Eugene SSO

Capacity: 36

Administrator: Casey Brill

Facility Phone: (541) 998-6060

Facility Fax: (541) 998-3747

Owner: FC Ranger OPS Junction City (OR), LLCCounty

Orig Lic. Date: 1998-06-16 Junction City, OR 97448

Renewal Date :2017-06-30 0

Units: 26

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

70M049

Juniper House

301 SW 28th Dr

Umatilla

Pendleton MSO

Capacity: 31

Administrator: Johnnie McQuilken

Facility Phone: (541) 278-0666

Facility Fax: (541) 278-1578

Owner: Assisted Living Facilities, Inc.County

Orig Lic. Date: 1991-04-03 Pendleton, OR 97801

Renewal Date :2018-03-31 0

Units: 25

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 45 of 85

Page 46: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50M422

Juniper House Memory Care

301 SW 28th Drive

Umatilla

Umatilla

Capacity: 16

Administrator: Johnnie McQuilkin

Facility Phone: (541) 278-0666

Facility Fax: (541) 278-1578

Owner: Assisted Living Facilities Inc.County

Orig Lic. Date: 2015-07-24 Pendleton, OR 97801

Renewal Date :2017-07-31 0

Units: 13

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 16

70M050

Kilchis House

4212 Marolf Place

Tillamook

Tillamook NWSDS

Capacity: 36

Administrator: Cathey Mason

Facility Phone: (503) 842-2204

Facility Fax: (503) 815-1694

Owner: Tillamook County CARE, Inc.County

Orig Lic. Date: 1994-12-19 Tillamook, OR 97141

Renewal Date :2017-09-30 0

Units: 30

Management: Tillamook County CARE, Inc.

Yes

Email: [email protected]

Other Services:

50M424

Kinsington at Redwood Park

1390 Dowell Road

Josephine

Medford

Capacity: 30

Administrator: Lynn Rawlins

Facility Phone: (541) 476-2536

Facility Fax: (541) 476-2456

Owner: Heirloom Living Centers, LLCCounty

Orig Lic. Date: 2015-11-12 Grants Pass, OR 97527

Renewal Date :2017-11-30 0

Units: 30

Management: Cameo Care Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 30

50R372

Kinsington Place

827 SW Kinsington Court

Josephine

Grants Pass DSO

Capacity: 16

Administrator: Alison Andrews

Facility Phone: (541) 955-9866

Facility Fax: (541) 955-9865

Owner: Heirloom Living Centers, LLCCounty

Orig Lic. Date: 2011-01-17 Grants Pass, OR 97526

Renewal Date :2017-01-31 0

Units: 15

Management: Heirloom Living Centers, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 16

70M053

Lakeview Senior Living

2690 NE Yacht

Lincoln

Toledo/Lincoln SSO

Capacity: 67

Administrator: Darcy Hood

Facility Phone: (541) 994-7400

Facility Fax: (541) 994-5678

Owner: Lakeview Operations, LLCCounty

Orig Lic. Date: 1995-11-01 Lincoln City, OR 97367

Renewal Date :2016-09-30 0

Units: 56

Management: Westmont Living, Inc.

Yes

Email: [email protected]

Other Services:

70M051

Lancaster Assisted Living

4156 Market St NE

Marion

Salem NWSDS

Capacity: 50

Administrator: Peggy Cruz

Facility Phone: (503) 364-3383

Facility Fax: (503) 371-0498

Owner: Lancaster Assisted Living LLCCounty

Orig Lic. Date: 1997-03-21 Salem, OR 97301

Renewal Date :2017-03-31 0

Units: 42

Management: Senior Living Management, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 46 of 85

Page 47: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M052

Lancaster Village

4148 Market St NE

Marion

Salem NWSDS

Capacity: 36

Administrator: Judy Belt

Facility Phone: (503) 364-3383

Facility Fax: (503) 364-6433

Owner: Lancaster Village, LLCCounty

Orig Lic. Date: 1990-02-01 Salem, OR 97301

Renewal Date :2017-01-31 0

Units: 32

Management: Senior Living Services, Inc.

Yes

Email: [email protected]

Other Services:

70A312

Laurel Parc at Bethany

15850 NW Central Drive

Washington

Beaverton SPD

Capacity: 153

Administrator: Tina Tittle

Facility Phone: (503) 533-7979

Facility Fax: (503) 906-5796

Owner: Laurel Parc AL at Bethany, LLCCounty

Orig Lic. Date: 2009-04-01 Portland, OR 97229

Renewal Date :2017-04-30 0

Units: 102

Management: Laurel Parc AL at Bethany, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 23

50R333

Laurel Pines Retirement Lodge

3100 Avenue A

Jackson

Medford AAA

Capacity: 56

Administrator: Kathleen A Adamson

Facility Phone: (541) 830-7800

Facility Fax: (541) 830-7802

Owner: Laurel Pines, Inc.County

Orig Lic. Date: 2005-06-15 White City, OR 97503

Renewal Date :2016-12-31 0

Units: 28

Management: Dakavia Management, Corp.

Yes

Email: [email protected]

Other Services:

70M252

Laurelhurst House

15 SE 55th Ave

Multnomah

E County ASD

Capacity: 38

Administrator: Ben Brandt

Facility Phone: (503) 234-5050

Facility Fax: (503) 234-9090

Owner: Laurelhurst House, LLCCounty

Orig Lic. Date: 2000-11-17 Portland, OR 97215

Renewal Date :2016-11-30 0

Units: 38

Management: Touchstone Communities, LLC

Yes

Email: [email protected]

Other Services:

70M242

Lone Oak Assisted Living Facility

2615 Lone Oak Way

Lane

Eugene SSO

Capacity: 85

Administrator: Amanda Boehlke

Facility Phone: (541) 463-7700

Facility Fax: (541) 461-0539

Owner: LSREF Golden Ops 14 (OR) LLCCounty

Orig Lic. Date: 2000-09-15 Eugene, OR 97402

Renewal Date :2017-01-31 0

Units: 70

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

5MA080

Lydia's House

5353 SE Columbus St

Linn

Albany SSO

Capacity: 28

Administrator: Mary Scott

Facility Phone: (541) 928-4728

Facility Fax: (541) 917-1399

Owner: Mennonite Home Of Albany, Inc.County

Orig Lic. Date: 1980-01-01 Albany, OR 97321

Renewal Date :2016-08-31 0

Units: 24

Management: Mennonite Home Of Albany, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 28

Tuesday, July 05, 2016 Page 47 of 85

Page 48: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M216

Macdonald Residence

605 NW Couch Street

Multnomah

W Portland

Capacity: 54

Administrator: Monique Mills

Facility Phone: (503) 241-7374

Facility Fax: (503) 241-7375

Owner: Macdonald Residence Limited PartnershipCounty

Orig Lic. Date: 1999-09-01 Portland, OR 97209

Renewal Date :2017-08-31 0

Units: 54

Management: Mennonite Management Services, Inc.

Yes

Email: [email protected]

Other Services:

70M056

Magnolia Gardens Assisted Retirement Living

1425 Daugherty

Lane

Eugene SSO

Capacity: 56

Administrator: Teresa Taylor

Facility Phone: (541) 942-0054

Facility Fax: (541) 942-3994

Owner: Magnolia Gardens Assisted Retirement Living LLCCounty

Orig Lic. Date: 1996-07-08 Cottage Grove, OR 97424

Renewal Date :2016-06-30 0

Units: 56

Management: Magnolia Gardens L.L.C.

Yes

Email: [email protected]

Other Services:

50R314

Magnolia Village Memory Care Community

1355 Daugherty

Lane

Eugene SSO

Capacity: 15

Administrator: Teresa Taylor

Facility Phone: (541) 942-8966

Facility Fax: (541) 942-8915

Owner: Magnolia Village, LLCCounty

Orig Lic. Date: 2003-04-04 Cottage Grove, OR 97424

Renewal Date :2017-04-30 0

Units: 15

Management: Magnolia Gardens, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 15

50R278

Manor Special Care Center

1200 Mira Mar Ave.

Jackson

Medford AAA

Capacity: 25

Administrator: Laura Herman

Facility Phone: (541) 857-7715

Facility Fax: (541) 857-7719

Owner: Rogue Valley Manor, Inc.County

Orig Lic. Date: 2001-05-29 Medford, OR 97504

Renewal Date :2017-05-31 0

Units: 13

Management: Pacific Retirement Services, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 25

50R363

Manor Terrace Care Suites

1250 Mira Mar Avenue

Jackson

Medford SSO

Capacity: 30

Administrator: Jill Howard

Facility Phone: (541) 857-7777

Facility Fax: (541) 857-7599

Owner: Rogue Valley ManorCounty

Orig Lic. Date: 2009-10-21 Medford, OR 97504

Renewal Date :2017-10-31 0

Units: 28

Management: Pacific Retirement Services, Inc.

Non Medicaid

Email: [email protected]

Other Services:

50M425

Maple Valley Dementia Care

219 NE Fircrest Drive

Yamhill

NWSDS

Capacity: 28

Administrator: Tammy Perez

Facility Phone: (503) 883-9385

Facility Fax: (360) 891-7162

Owner: Maple Valley Dementia Care, Inc.County

Orig Lic. Date: 2015-11-19 McMinnville, OR 97128

Renewal Date :2017-11-30 0

Units: 28

Management: Maple Valley Dementia Care, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 28

Tuesday, July 05, 2016 Page 48 of 85

Page 49: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M257

Marie Rose Center Assisted Living

17360 Holy Names Drive

Clackamas

Milwaukie SPD

Capacity: 79

Administrator: Lynn Szender

Facility Phone: (503) 675-2475

Facility Fax: (503) 675-2458

Owner: Mary's Woods at Marylhurst, Inc.County

Orig Lic. Date: 2001-02-22 Lake Oswego, OR 97034

Renewal Date :2017-02-28 0

Units: 70

Management: Mary's Woods at Marylhurst, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 23

50R401

Marie Rose Residential Care

17360 Holy Names Drive

Clackamas

Milwaukie SPD

Capacity: 26

Administrator: Lynn Szender

Facility Phone: (503) 675-2475

Facility Fax: (503) 534-3937

Owner: Mary's Woods at Marylhurst, Inc.County

Orig Lic. Date: 2014-01-01 Lake Oswego, OR 97034

Renewal Date :2018-01-31 0

Units: 26

Management: Mary's Woods at Marylhurst, Inc.

Yes

Email: [email protected]

Other Services:

50M423

Marjorie House Memory Care Community

2855 NE Cumulus Avenue

Yamhill

NWSDS

Capacity: 45

Administrator: Donna Fuller-Archer

Facility Phone: (503) 474-4222

Facility Fax: (503) 474-4220

Owner: Marjorie House McMinnville, LLCCounty

Orig Lic. Date: 2015-11-01 McMinnville, OR 97128

Renewal Date :2017-11-30 0

Units: 45

Management: Marjorie House McMinnville, LLC

Yes

Email: [email protected]

Other Services: ACU 45

70A057

Markham House Retirement Community

10606 SW Capitol Hwy

Multnomah

W Portland

Capacity: 63

Administrator: Darrin Buckner

Facility Phone: (503) 244-9500

Facility Fax: (503) 244-1022

Owner: PORTMH, LLCCounty

Orig Lic. Date: 1994-03-01 Portland, OR 97219

Renewal Date :2018-06-30 0

Units: 54

Management: Leisure Care, LLC

Non Medicaid

Email: [email protected]

Other Services:

50A244

Marquis Autumn Hills Residential Memory Care

6630 SW Beaverton-Hillsdale Hwy.

Washington

WCDAVS

Capacity: 22

Administrator: Jaron Sue

Facility Phone: (503) 292-7874

Facility Fax: (503) 292-2359

Owner: Marquis Companies II, Inc.County

Orig Lic. Date: 2000-04-07 Portland, OR 97225

Renewal Date :2017-04-30 0

Units: 15

Management: Marquis Companies I, Inc.

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 22

70M100

Marquis Forest Grove Assisted Living

3336 19th Ave

Washington

WCDAVS

Capacity: 70

Administrator: Shehani Fernando

Facility Phone: (503) 359-1129

Facility Fax: (503) 357-4449

Owner: Marquis Companies II, Inc.County

Orig Lic. Date: 1996-08-09 Forest Grove, OR 97116

Renewal Date :2017-04-30 0

Units: 58

Management: Marquis Companies I, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 49 of 85

Page 50: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M099

Marquis Hope Village ALF

1589 S Ivy

Clackamas

Canby SPD

Capacity: 92

Administrator: Marci Bird

Facility Phone: (503) 266-2444

Facility Fax: (503) 266-6725

Owner: Marquis Companies I, Inc.County

Orig Lic. Date: 1998-03-04 Canby, OR 97013

Renewal Date :2018-02-28 0

Units: 80

Management: Marquis Companies I, Inc.

Yes

Email: [email protected]

Other Services:

70A288

Marquis Piedmont Assisted Living

319 NE Russet St.

Multnomah

NE Portland ASO/DSO

Capacity: 80

Administrator: Theresa Decker

Facility Phone: (503) 289-5571

Facility Fax: (503) 286-0635

Owner: Marquis Companies II, Inc.County

Orig Lic. Date: 2003-05-19 Portland, OR 97211

Renewal Date :2017-04-30 0

Units: 80

Management: Marquis Companies I, Inc.

Yes

Email: [email protected]

Other Services:

70A324

Marquis Tualatin Assisted Living

19945 SW Boones Ferry Road

Washington

WCDAVS

Capacity: 87

Administrator: Lindsey Schaub

Facility Phone: (503) 621-5400

Facility Fax: (503) 621-5501

Owner: Marquis Companies II, Inc.County

Orig Lic. Date: 2014-07-21 Tualatin, OR 97062

Renewal Date :2018-07-31 0

Units: 80

Management: Marquis Companies I, Inc.

Yes

Email: [email protected]

Other Services:

70A286

Marquis Wilsonville Assisted Living

30900 SW Parkway Ave

Clackamas

Canby SPD

Capacity: 72

Administrator: McKenzie Dodge

Facility Phone: (503) 682-2330

Facility Fax: (503) 682-2208

Owner: Marquis Companies II, Inc.County

Orig Lic. Date: 2003-02-07 Wilsonville, OR 97070

Renewal Date :2017-04-30 0

Units: 60

Management: Marquis Companies I, Inc.

Yes

Email: [email protected]

Other Services:

50R381

Maryville Memory Care

14645 SW Farmington Road

Washington

Beaverton SPD

Capacity: 16

Administrator: Michael Kilbury

Facility Phone: (503) 643-8626

Facility Fax: (503) 520-1435

Owner: Sisters of St. Mary of Oregon Maryville Corp.County

Orig Lic. Date: 2011-10-13 Beaverton, OR 97007

Renewal Date :2017-10-31 0

Units: 15

Management: Sisters of St. Mary of Oregon Maryville Corp.

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 16

70M238

McKay Creek Estates

1601 Southgate Place

Umatilla

Pendleton MSO

Capacity: 60

Administrator: Rick Hoisington

Facility Phone: (541) 276-1987

Facility Fax: (541) 278-4788

Owner: Pendleton Ventures, L.L.C.County

Orig Lic. Date: 2000-07-12 Pendleton, OR 97801

Renewal Date :2018-06-30 0

Units: 44

Management: Prestige Senior Living, L.L.C.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 50 of 85

Page 51: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R410

McKenzie Living

6452 "A" Street

Lane

Eugene LCOG

Capacity: 21

Administrator: Yvonne Starr

Facility Phone: (541) 744-9817

Facility Fax: (541) 744-0220

Owner: McKenzie Living, Inc.County

Orig Lic. Date: 2014-05-21 Springfield, OR 97478

Renewal Date :2018-05-31 0

Units: 21

Management: McKenzie Living, Inc.

Yes

Email: [email protected]

Other Services:

70M058

McKillop Residence

500 Conifer Circle

Marion

Salem NWSDS

Capacity: 60

Administrator: Shauna Garza

Facility Phone: (503) 769-8900

Facility Fax: (503) 769-0950

Owner: Janmaur II, L.L.C.County

Orig Lic. Date: 1998-04-16 Sublimity, OR 97385

Renewal Date :2018-03-31 0

Units: 50

Management: Marian Estates Support Services

Yes

Email: [email protected]

Other Services:

50R357

McLoughlin Memory Care

1145 Molalla Avenue

Clackamas

Milwaukie SPD

Capacity: 28

Administrator: Roselynn Rockwood

Facility Phone: (503) 655-3337

Facility Fax: (503) 656-6939

Owner: McLoughlin Place Operations, LLCCounty

Orig Lic. Date: 2009-02-01 Oregon City, OR 97045

Renewal Date :2016-10-31 0

Units: 24

Management: Milestone Retirement Communities, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 28

70M059

McLoughlin Place Senior Living

1153 Molalla Ave

Clackamas

Milwaukie SPD

Capacity: 74

Administrator: Sherry Andrus

Facility Phone: (503) 655-3337

Facility Fax: (503) 656-6939

Owner: McLoughlin Place Operations, LLCCounty

Orig Lic. Date: 1997-03-30 Oregon City, OR 97045

Renewal Date :2016-10-31 0

Units: 70

Management: Milestone Retirement Communities, LLC

Yes

Email: [email protected]

Other Services:

70M060

Meadow Creek Village Assisted Living

3988 12th St SE

Marion

Salem NWSDS

Capacity: 52

Administrator: Sarah Loucks

Facility Phone: (503) 375-9732

Facility Fax: (503) 375-2144

Owner: Cascade Living Group - Oregon, LLCCounty

Orig Lic. Date: 1992-07-08 Salem, OR 97302

Renewal Date :2017-05-31 0

Units: 44

Management: Cascade Living Group, Inc.

Yes

Email: [email protected]

Other Services:

70M061

Meadowbrook Place

4000 Cedar St

Baker

Baker City

Capacity: 60

Administrator: Suzanne Miller

Facility Phone: (541) 523-6333

Facility Fax: (541) 523-9166

Owner: Meadowbrook Place Operations, LLCCounty

Orig Lic. Date: 1992-12-02 Baker City, OR 97814

Renewal Date :2016-10-31 0

Units: 50

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 51 of 85

Page 52: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50M218

Meadows Courtyard

13637 Garden Meadow Drive

Clackamas

Milwaukie SPD

Capacity: 42

Administrator: Pamalynn Richardson

Facility Phone: (503) 656-8113

Facility Fax: (503) 650-7486

Owner: Meadows Courtyard, Inc.County

Orig Lic. Date: 1999-02-17 Oregon City, OR 97045

Renewal Date :2017-02-28 0

Units: 37

Management: Meadows Courtyard, Inc.

Yes

Email: [email protected]

Other Services:

70A306

Middlefield Oaks Assisted Living Community

1500 Village Drive

Lane

Eugene AAA

Capacity: 85

Administrator: Tesla Thoms

Facility Phone: (541) 767-0080

Facility Fax: (541) 767-1181

Owner: Middlefield Oaks Assisted Living, LLCCounty

Orig Lic. Date: 2006-11-17 Cottage Grove, OR 97424

Renewal Date :2017-07-31 0

Units: 62

Management: Frontier Management, Inc., A Corporation of Co

Yes

Email: [email protected]

Other Services:

50R345

Middlefield Oaks Memory Care Community

1500 Village Drive

Lane

Eugene AAA

Capacity: 36

Administrator: Shannon Black

Facility Phone: (541) 767-0080

Facility Fax: (541) 767-1181

Owner: Middlefield Oaks Assisted Living, LLCCounty

Orig Lic. Date: 2006-11-17 Cottage Grove, OR 97424

Renewal Date :2017-07-31 0

Units: 24

Management: Frontier Management, Inc., A Corporation of Co

Yes

Email: [email protected]

Other Services: MCC, ACU 36

50M081

Milwaukie Care Center

14107 SE Redwood Ave

Clackamas

Milwaukie SPD

Capacity: 23

Administrator: Jannice Steeves

Facility Phone: (503) 659-1077

Facility Fax: (503) 659-7370

Owner: Milwaukie Care Center, Inc.County

Orig Lic. Date: 1992-08-30 Milwaukie, OR 97222

Renewal Date :2016-08-31 0

Units: 14

Management: Milwaukie Care Center, Inc.

Yes

Email: [email protected]

Other Services:

70A317

Mirabella at South Waterfront

3550 SW Bond Ave.

Multnomah

Milwaukie SPD

Capacity: 24

Administrator: Sharon McCartney

Facility Phone: (503) 688-6514

Facility Fax: (503) 688-6555

Owner: Mirabella at South WaterfrontCounty

Orig Lic. Date: 2010-10-07 Portland, OR 97239

Renewal Date :2016-10-31 0

Units: 16

Management: Pacific Retirement Services, Inc.

Non Medicaid

Email: [email protected]

Other Services:

50R293

Miramont Pointe

11520 SE Sunnyside Rd

Clackamas

Milwaukie SPD

Capacity: 186

Administrator: Julie Campbell-Taylor

Facility Phone: (503) 698-1600

Facility Fax: (503) 652-0168

Owner: MP, LLCCounty

Orig Lic. Date: 2002-01-10 Clackamas, OR 97015

Renewal Date :2017-03-31 0

Units: 143

Management: MP, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 21

Tuesday, July 05, 2016 Page 52 of 85

Page 53: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50A214

Monterey Court Memory Care

8915 SE Monterey

Clackamas

Milwaukie SPD

Capacity: 48

Administrator: Amy Landon

Facility Phone: (503) 654-3200

Facility Fax: (503) 654-3800

Owner: Monterey Court Ventures, LLCCounty

Orig Lic. Date: 1999-08-13 Happy Valley, OR 97086

Renewal Date :2017-03-31 0

Units: 24

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 48

70M233

Morrow Heights Retirement & Assisted Living Community

176 Wards Creek Road

Jackson

Medford AAA

Capacity: 53

Administrator: Terry O'Donnell

Facility Phone: (541) 582-8200

Facility Fax: (541) 582-6818

Owner: LSREF Golden Ops 14 (OR) LLCCounty

Orig Lic. Date: 2000-04-14 Rogue River, OR 97537

Renewal Date :2017-01-31 0

Units: 43

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

50R322

Mountain View Residential Care Facility

1220 SE 282nd Ave.

Multnomah

Mid-Mult

Capacity: 23

Administrator: Charlotte White

Facility Phone: (503) 666-9309

Facility Fax: (503) 667-6894

Owner: BME Enterprises, Inc.County

Orig Lic. Date: 2003-11-06 Gresham, OR 97080

Renewal Date :2017-11-30 0

Units: 21

Management: Fred T. & Elizabeth C. Asa

Yes

Email: lis_asa@@yahoo.com

Other Services:

50R085

Mt. Angel Towers

One Towers Lane Box 2120

Marion

Woodburn NWSDS

Capacity: 29

Administrator: Carina Torres

Facility Phone: (503) 845-7211

Facility Fax: (503) 845-7210

Owner: Mt. Angel Towers, Oregon, Ltd.County

Orig Lic. Date: 1994-07-18 Mt. Angel, OR 97362

Renewal Date :2016-06-30 0

Units: 29

Management: Mt. Angel Towers, Oregon, Ltd.

Non Medicaid

Email: [email protected]

Other Services:

50R390

Mt. Bachelor Memory Care

20225 Powers Road

Deschutes

Bend APD

Capacity: 56

Administrator: Mallory Dacosta

Facility Phone: (541) 318-3322

Facility Fax: (541) 318-3348

Owner: MBMC 1, LLCCounty

Orig Lic. Date: 2013-05-13 Bend, OR 97702

Renewal Date :2017-05-31 0

Units: 56

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 56

50M086

Mt. Scott Residential Care Home

8014 SE Lambert St

Multnomah

SE Portland ASO

Capacity: 46

Administrator: Dennis Murphy

Facility Phone: (503) 774-1329

Facility Fax: (503) 774-3037

Owner: Sistere, Inc.County

Orig Lic. Date: 1981-01-01 Portland, OR 97206

Renewal Date :2017-09-30 0

Units: 26

Management: Sistere, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 53 of 85

Page 54: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50M088

Myrtle Point Care Center RCF

637 Ash St

Coos

Coos Bay MSO

Capacity: 20

Administrator: Fritzie Vader

Facility Phone: (541) 572-2066

Facility Fax: (541) 572-5477

Owner: Care Centers Management, Inc.County

Orig Lic. Date: 1992-02-01 Myrtle Point, OR 97458

Renewal Date :2018-01-31 0

Units: 20

Management: Dakavia Management, Corp.

Yes

Email: [email protected]

Other Services:

70M064

Neawanna By The Sea

20 North Wahanna Rd

Clatsop

Warrenton NWSDS

Capacity: 48

Administrator: Tammy Tucker

Facility Phone: (503) 738-5526

Facility Fax: (503) 738-5569

Owner: FC Ranger OPS Neawanna (OR), LLCCounty

Orig Lic. Date: 1990-11-06 Seaside, OR 97138

Renewal Date :2017-06-30 0

Units: 40

Management: Neawanna Care Properties, LLC

Yes

Email: [email protected]

Other Services:

70M065

Nehalem Bay House

35385 Tohl Ave

Tillamook

Tillamook NWSDS

Capacity: 44

Administrator: Blanca Turrieta

Facility Phone: (503) 368-6445

Facility Fax: (503) 368-6468

Owner: Tillamook County CARE, Inc.County

Orig Lic. Date: 1998-08-06 Nehalem, OR 97131

Renewal Date :2017-09-30 0

Units: 34

Management: Tillamook County CARE, Inc.

Yes

Email: [email protected]

Other Services:

70M066

Northridge Center

3737 S Pacific Hwy

Jackson

Medford

Capacity: 61

Administrator: Memory Dent

Facility Phone: (541) 535-5497

Facility Fax: (541) 535-1221

Owner: Northridge Center, Inc.County

Orig Lic. Date: 1994-06-04 Medford, OR 97501

Renewal Date :2018-05-31 0

Units: 55

Management: Northridge Center, Inc.

Yes

Email: [email protected]

Other Services:

70M237

Nyssa Gardens Assisted Living Facility

1101 Park Avenue

Malheur

Ontario MSO

Capacity: 36

Administrator: April Aldred

Facility Phone: (541) 372-4024

Facility Fax: (541) 372-0126

Owner: Malheur Memorial Hospital DistrictCounty

Orig Lic. Date: 2000-05-22 Nyssa, OR 97913

Renewal Date :2018-05-31 0

Units: 32

Management: Malheur Memorial Health District

Yes

Email: [email protected]

Other Services:

50M133

Oak Lane Retirement

727 SW Rogue River Ave

Josephine

Grants Pass MSO

Capacity: 74

Administrator: Terri Henry

Facility Phone: (541) 476-7727

Facility Fax: (541) 479-1362

Owner: TSL Oak Lane, LLCCounty

Orig Lic. Date: 1994-04-25 Grants Pass, OR 97526

Renewal Date :2018-02-28 0

Units: 59

Management: Tierra Senior Living, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 54 of 85

Page 55: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M225

Oak Park Assisted Living Community

1400 NE Rocky Ridge Dr.

Douglas

Roseburg AAA

Capacity: 76

Administrator: Lindsey Keller

Facility Phone: (541) 464-5656

Facility Fax: (541) 677-7063

Owner: Roseburg Assisted Living, LLCCounty

Orig Lic. Date: 2000-01-05 Roseburg, OR 97470

Renewal Date :2018-01-31 0

Units: 63

Management: Bonaventure Senior Living

Yes

Email: [email protected]

Other Services:

70M095

Oaks At Lebanon, The

621 West Oak

Linn

Albany SSO

Capacity: 70

Administrator: Angelic Kutsch

Facility Phone: (541) 258-7777

Facility Fax: (541) 258-7255

Owner: FM Oaks, LLCCounty

Orig Lic. Date: 1992-04-01 Lebanon, OR 97355

Renewal Date :2017-01-31 0

Units: 62

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

50R171

Oaktree Residential Living

5030 West Port St PO Box 22636

Lane

Eugene SSO

Capacity: 16

Administrator: Elkhan Babayev

Facility Phone: (541) 607-0688

Facility Fax: (541) 688-6404

Owner: Elman's House Corp.County

Orig Lic. Date: 1998-08-28 Eugene, OR 97402

Renewal Date :2016-11-30 0

Units: 16

Management: Elman's House Corp.

Yes

Email: [email protected]

Other Services:

5MA222

Ocean Park

984 Parkview Drive

Curry

Gold Beach MSO

Capacity: 55

Administrator: Georgia Borowski

Facility Phone: (541) 469-6817

Facility Fax: (541) 469-3768

Owner: ARHC OPBROOR01 TRS, LLCCounty

Orig Lic. Date: 1999-08-25 Brookings, OR 97415

Renewal Date :2017-09-30 0

Units: 40

Management: Ocean Park Care Properties

Yes

Email: [email protected]

Other Services: MCC, ACU 55

70A302

Ocean Ridge Retirement and Assisted Living Community

1855 SE Ocean Blvd.

Coos

Coos Bay SPD

Capacity: 100

Administrator: Diane Mason

Facility Phone: (541) 267-4000

Facility Fax: (541) 267-4411

Owner: ARHC ORCOOOR01 TRS, LLCCounty

Orig Lic. Date: 2006-03-31 Coos Bay, OR 97420

Renewal Date :2017-07-31 0

Units: 81

Management: FM Ocean Ridge, LLC

Yes

Email: [email protected]

Other Services:

70M068

Oceanview Assisted Living Residence

525 NE 71st

Lincoln

Toledo/Lincoln SSO

Capacity: 84

Administrator: Steven Bae

Facility Phone: (541) 574-0550

Facility Fax: (541) 574-7713

Owner: Newport Assisted Living, LLCCounty

Orig Lic. Date: 1997-11-28 Newport, OR 97365

Renewal Date :2017-11-30 0

Units: 71

Management: Westmont Living, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 55 of 85

Page 56: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R091

Odd Fellows Home Of Oregon

3102 SE Holgate Blvd

Multnomah

SE Ptld ADS

Capacity: 115

Administrator: Kim Williams

Facility Phone: (503) 872-1239

Facility Fax: (503) 872-1277

Owner: Odd Fellows Home of OregonCounty

Orig Lic. Date: 1978-02-01 Portland, OR 97202

Renewal Date :2018-03-31 0

Units: 93

Management: Odd Fellows Home of Oregon

Yes

Email: [email protected]

Other Services:

50M092

O'Hara's Manor

1250 SE Roberts

Multnomah

Mid-County ASD

Capacity: 32

Administrator: Cynthia Mares

Facility Phone: (503) 667-5430

Facility Fax: (503) 492-0359

Owner: O'Hara's Manor, Inc.County

Orig Lic. Date: 1979-12-15 Gresham, OR 97080

Renewal Date :2016-12-31 0

Units: 30

Management: O'Hara's Manor, Inc.

Non Medicaid

Email: [email protected]

Other Services:

70M210

Orchards Assisted Living

1018 Royal Court

Jackson

Medford AAA

Capacity: 72

Administrator: Pam Roberts

Facility Phone: (541) 776-5255

Facility Fax: (541) 776-5227

Owner: Medford Assisted Living, LLCCounty

Orig Lic. Date: 1999-02-05 Medford, OR 97504

Renewal Date :2017-04-30 0

Units: 61

Management: Woollard Ipsen Management, LLC

Yes

Email: [email protected]

Other Services:

50M094

Oregon City Residential Care

515 10th St

Clackamas

Milwaukie SPD

Capacity: 50

Administrator: Arthur Johnson

Facility Phone: (503) 656-0855

Facility Fax: (503) 657-4212

Owner: Valley View Care Centers, Inc.County

Orig Lic. Date: 1978-04-01 Oregon City, OR 97045

Renewal Date :2017-01-31 0

Units: 40

Management: Valley View Care Centers, Inc.

Yes

Email: [email protected]

Other Services:

70M027

Oregon Retirement Center

1010 NE 3rd

Umatilla

Pendleton MSO

Capacity: 44

Administrator: Sean Moon

Facility Phone: (541) 938-5693

Facility Fax: (541) 938-4490

Owner: Evergreen Oregon Healthcare Orchards Retirement, County

Orig Lic. Date: 1993-09-10 Milton-Freewater, OR 97862

Renewal Date :2017-04-30 0

Units: 34

Management: Evergreen Healthcare Management, LLC

Yes

Email: [email protected]

Other Services:

50R336

Oswego Grove

4550 SW Carman Drive

Clackamas

Milwaukie SPD

Capacity: 31

Administrator: Jason Wart

Facility Phone: (503) 675-6055

Facility Fax: (503) 675-6077

Owner: Avamere Lake Oswego Operations Investors, LLCCounty

Orig Lic. Date: 2005-12-27 Lake Oswego, OR 97035

Renewal Date :2017-12-31 0

Units: 31

Management: Avamere Lake Oswego Operations Investors, L

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 31

Tuesday, July 05, 2016 Page 56 of 85

Page 57: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A304

Oswego Place Assisted Living Community

17450 Pilkington Rd.

Clackamas

Milwaukie SPD

Capacity: 79

Administrator: McKenzie Owens

Facility Phone: (503) 697-1025

Facility Fax: (503) 697-1026

Owner: Oswego Place Assisted Living Community, LLCCounty

Orig Lic. Date: 2006-06-02 Lake Oswego, OR 97035

Renewal Date :2016-06-30 0

Units: 72

Management: Bonaventure Senior Living

Non Medicaid

Email: [email protected]

Other Services:

50M096

Our House Of Portland

2727 SE Alder

Multnomah

E County ASD

Capacity: 14

Administrator: Kimberly Hutchinson

Facility Phone: (503) 234-0175

Facility Fax: (503) 236-7129

Owner: Our House Of Portland, IncCounty

Orig Lic. Date: 1990-03-01 Portland, OR 97214

Renewal Date :2016-10-31 0

Units: 14

Management: Our House of Portland, Inc.

Yes

Email: [email protected]

Other Services:

5MA223

Pacific Gardens Alzheimer's Special Care Center

17309 NE Glisan

Multnomah

NE Portland ASO/DSO

Capacity: 60

Administrator: Darren Burch

Facility Phone: (503) 253-4920

Facility Fax: (503) 253-4819

Owner: Erwin Family Properties II, LLCCounty

Orig Lic. Date: 1996-11-01 Portland, OR 97230

Renewal Date :2016-06-30 0

Units: 40

Management: JEA Senior Living

Yes

Email: [email protected]

Other Services: MCC, ACU 60

70M039

Pacific View Assisted Living Community

1000 6th Ave West

Coos

Coos Bay MSO

Capacity: 85

Administrator: Debbie Wilson

Facility Phone: (541) 347-7502

Facility Fax: (541) 347-7802

Owner: Bandon Senior Living, LLCCounty

Orig Lic. Date: 1995-02-07 Bandon, OR 97411

Renewal Date :2017-12-31 0

Units: 68

Management: Seasons Management, LLC

Yes

Email: [email protected]

Other Services:

5MA137

Pacific View Memory Care Community

1000 6th Ave West

Coos

Coos Bay MSO

Capacity: 30

Administrator: Debbie Wilson

Facility Phone: (541) 347-7502

Facility Fax: (541) 347-7802

Owner: Bandon Senior Living, LLCCounty

Orig Lic. Date: 1994-11-01 Bandon, OR 97411

Renewal Date :2017-12-31 0

Units: 30

Management: Seasons Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 30

50R009

Pacifica Senior Living Calaroga Terrace

1400 NE Second Ave

Multnomah

Portland SE ASO

Capacity: 74

Administrator: Rebecca Mock

Facility Phone: (503) 234-8271

Facility Fax: (503) 239-3399

Owner: Pacifica Senior Living, LLCCounty

Orig Lic. Date: 1991-06-01 Portland, OR 97232

Renewal Date :2017-02-28 0

Units: 63

Management: Pacifica Senior Living, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 57 of 85

Page 58: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M024

Pacifica Senior Living Klamath Falls

2130 Eldorado Blvd

Klamath

Klamath Falls MSO

Capacity: 70

Administrator: Stephanie Weiser

Facility Phone: (541) 882-4830

Facility Fax: (541) 882-8308

Owner: Pacifica SL Klamath Falls, LLCCounty

Orig Lic. Date: 1997-04-08 Klamath Falls, OR 97601

Renewal Date :2018-05-31 0

Units: 60

Management: Pacifica Senior Living, LLC

Yes

Email: [email protected]

Other Services:

5MA170

Pacifica Senior Living McMinnville

320 SW Hill Road

Yamhill

McMinnville NWSDS

Capacity: 37

Administrator: Joeda Simonson

Facility Phone: (503) 472-3509

Facility Fax: (503) 472-3929

Owner: Pacifica SL McMinnville, LLCCounty

Orig Lic. Date: 1998-09-01 McMinnville, OR 97128

Renewal Date :2018-05-31 0

Units: 37

Management: Pacifica Senior Living, LLC

Yes

Email: New email coming

Other Services: MCC, ACU 37

5MA160

Pacifica Senior Living Portland

1808 SE 182nd Ave

Multnomah

Mid-County ASD

Capacity: 114

Administrator: Dana Klopfenstein

Facility Phone: (503) 492-6942

Facility Fax: (503) 492-2810

Owner: Pacifica Senior Living, LLCCounty

Orig Lic. Date: 1997-08-01 Portland, OR 97233

Renewal Date :2018-03-31 0

Units: 98

Management: Pacifica Senior Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 114

70M071

Parkhurst Place

2450 May St

Hood River

The Dalles MSO

Capacity: 35

Administrator: Timothy Dufour

Facility Phone: (541) 387-4600

Facility Fax: (541) 387-4472

Owner: PARKHURST AID OPCO, LLCCounty

Orig Lic. Date: 1995-10-26 Hood River, OR 97031

Renewal Date :2017-07-31 0

Units: 30

Management: PARKHURST AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

70M072

Parkland Village Retirement Community

3121 NE Cumulus Avenue

Yamhill

McMinnville NWSDS

Capacity: 60

Administrator: Luke Bolling

Facility Phone: (503) 435-1499

Facility Fax: (503) 434-5190

Owner: Cascade Living Group - Oregon, LLCCounty

Orig Lic. Date: 1996-09-24 McMinnville, OR 97128

Renewal Date :2017-05-31 0

Units: 50

Management: Cascade Living Group, Inc.

Yes

Email: [email protected]

Other Services:

70M023

Parkview Assisted Living

10801 NE Weidler

Multnomah

NE Portland ASO/DSO

Capacity: 77

Administrator: Steven C. Williams

Facility Phone: (503) 255-0685

Facility Fax: (503) 256-1140

Owner: Oregon Baptist Retirement HomeCounty

Orig Lic. Date: 1996-08-12 Portland, OR 97220

Renewal Date :2018-07-31 0

Units: 63

Management: Oregon Baptist Retirement Homes

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 58 of 85

Page 59: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R413

Parkview Memory Care at Cherrywood Village

10721 SE Cherry Blossom Dr.

Multnomah

Mid-Mult ADS

Capacity: 38

Administrator: Julianne Foster

Facility Phone: (503) 408-0404

Facility Fax: (503) 946-0215

Owner: PAR, LLCCounty

Orig Lic. Date: 2014-08-07 Portland, OR 97216

Renewal Date :2016-08-31 0

Units: 38

Management: PAR, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 38

70M230

Pelican Pointe Assisted Living Community

615 Washburn Way

Klamath

Klamath Falls MSO

Capacity: 75

Administrator: Linda Hall

Facility Phone: (541) 882-8900

Facility Fax: (541) 850-2459

Owner: ARHC PPKLAOR01 TRS, LLCCounty

Orig Lic. Date: 2000-03-03 Klamath Falls, OR 97603

Renewal Date :2017-03-31 0

Units: 64

Management: FM Pelican, LLC

Yes

Email: [email protected]

Other Services:

5MA131

Pelican Pointe Memory Care Community

615 Washburn Way

Klamath

Klamath Falls MSO

Capacity: 48

Administrator: Cathy Van Dyke

Facility Phone: (541) 882-8900

Facility Fax: (541) 850-2459

Owner: ARHC PPKLAOR01 TRS, LLCCounty

Orig Lic. Date: 2000-03-03 Klamath Falls, OR 97603

Renewal Date :2017-03-31 0

Units: 24

Management: FM Pelican, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 48

50R435

Petra Memory Care

950 South End Road

Clackamas

Clackamas

Capacity: 31

Administrator: Justin Hollingshead

Facility Phone: (971) 260-0175

Facility Fax:

Owner: Petra Memory Care, LLCCounty

Orig Lic. Date: 2016-06-29 Oregon City, OR 97045

Renewal Date :2018-06-30 0

Units: 31

Management: Avant Senior Housing and Consultants, LLC

Non Medicaid

Email: [email protected]

Other Services: ACU 31

70M206

Pheasant Pointe Assisted Living Community

835 E. Main Street

Clackamas

Canby SPD

Capacity: 61

Administrator: Chelsea Slaven

Facility Phone: (503) 829-3777

Facility Fax: (503) 829-7392

Owner: ARHC PPMOLOR01 TRS, LLCCounty

Orig Lic. Date: 1998-12-17 Molalla, OR 97038

Renewal Date :2017-07-31 0

Units: 45

Management: FM Pheasant Pointe, LLC

Yes

Email: [email protected]

Other Services:

50R352

Pheasant Pointe Memory Care Community

835 E. Main Street

Clackamas

Canby SPD

Capacity: 12

Administrator: Debra Mueller

Facility Phone: (503) 829-3777

Facility Fax: (503) 829-7392

Owner: ARHC PPMOLOR01 TRS, LLCCounty

Orig Lic. Date: 2007-12-21 Molalla, OR 97038

Renewal Date :2017-07-31 0

Units: 7

Management: FM Pheasant Pointe, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 12

Tuesday, July 05, 2016 Page 59 of 85

Page 60: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A293

Pioneer Place Assisted Living

1060 D Street W

Malheur

Ontario MSO

Capacity: 31

Administrator: Betsy Bates

Facility Phone: (541) 473-3131

Facility Fax: (541) 473-2842

Owner: Pioneer Nursing Home Health DistrictCounty

Orig Lic. Date: 2004-04-16 Vale, OR 97918

Renewal Date :2018-04-30 0

Units: 28

Management: Pioneer Nursing Home Health District

Yes

Email: [email protected]

Other Services:

70A298

Pioneer Village

805 N. 5th St.

Jackson

Medford AAA

Capacity: 60

Administrator: Jim Digerness

Facility Phone: (541) 899-6825

Facility Fax: (541) 899-4848

Owner: RSL Pioneer, LLCCounty

Orig Lic. Date: 2005-12-30 Jacksonville, OR 97530

Renewal Date :2017-07-31 0

Units: 51

Management: Radiant Senior Living, Inc.

Non Medicaid

Email: [email protected]

Other Services:

50M247

Pleasant Valley RCF

18857 SE Giese Rd.

Multnomah

Mid-County ADS

Capacity: 11

Administrator: Carmen Flores

Facility Phone: (503) 328-8486

Facility Fax: (503) 328-9613

Owner: BME Enterprises, Inc.County

Orig Lic. Date: 2000-05-03 Gresham, OR 97080

Renewal Date :2017-03-31 0

Units: 10

Management: BME Enterprises, Inc.

Yes

Email: [email protected]

Other Services:

70M073

Powell Valley Assisted Living Community

4001 SE 182nd Ave

Multnomah

Mid County ASD

Capacity: 115

Administrator: Pam Arvidson

Facility Phone: (503) 665-2496

Facility Fax: (503) 661-8720

Owner: PVALC-LLCCounty

Orig Lic. Date: 1989-10-01 Gresham, OR 97030

Renewal Date :2016-07-31 0

Units: 105

Management: Care Wise Management, Inc.

Yes

Email: [email protected]

Other Services:

5MA213

Powell Valley Memory Care Community

4001 SE 182nd Ave

Multnomah

Mid County ASD

Capacity: 42

Administrator: Laureen Manibusan

Facility Phone: (503) 665-2496

Facility Fax: (503) 661-8720

Owner: PVALC-LLCCounty

Orig Lic. Date: 1998-08-30 Gresham, OR 97030

Renewal Date :2017-08-31 0

Units: 36

Management: Care Wise Management, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 42

70M221

Prairie House Assisted Living Community

51485 Morson Street

Deschutes

Bend MSO

Capacity: 46

Administrator: Scott Nay

Facility Phone: (541) 536-8559

Facility Fax: (541) 536-1373

Owner: Assisted Living Alternatives, Inc.County

Orig Lic. Date: 1999-10-22 La Pine, OR 97739

Renewal Date :2017-10-31 0

Units: 46

Management: Ridgeline Management Co.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 60 of 85

Page 61: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R313

Prairie House Memory Care Community

51485 Morson St.

Deschutes

Bend MSO

Capacity: 18

Administrator: Scott Nay

Facility Phone: (541) 536-8559

Facility Fax: (541) 536-1373

Owner: Assisted Living Alternatives, Inc.County

Orig Lic. Date: 2003-04-08 La Pine, OR 97739

Renewal Date :2017-04-30 0

Units: 11

Management: Ridgeline Management Co.

Yes

Email: [email protected]

Other Services: MCC, ACU 18

5ME175

Premier Living Center

5120 SE 118th

Multnomah

Mid-Multnomah ASD

Capacity: 16

Administrator: Gelissa Crichton

Facility Phone: (503) 762-3413

Facility Fax: (503) 762-3428

Owner: Premier Living Center, Inc.County

Orig Lic. Date: 1998-09-04 Portland, OR 97266

Renewal Date :2016-09-30 0

Units: 12

Management: Premier Living Center, Inc.

Yes

Email: [email protected]

Other Services:

70A292

Prestige Senior Living Arbor Place

3150 Juanipero Way

Jackson

Medford AAA

Capacity: 64

Administrator: Linda Green

Facility Phone: (541) 773-5380

Facility Fax: (541) 773-5378

Owner: CHP Medford -Arbor Place OR Tenant Corp.County

Orig Lic. Date: 2003-11-10 Medford, OR 97504

Renewal Date :2017-12-31 0

Units: 54

Management: Prestige Senior Living, LLC

Yes

Email: [email protected]

Other Services:

50R323

Prestige Senior Living Arbor Place Memory Care

3150 Juanipero Way

Jackson

Medford AAA

Capacity: 18

Administrator: Linda Green

Facility Phone: (541) 773-5380

Facility Fax: (541) 773-5378

Owner: CHP Medford -Arbor Place OR Tenant Corp.County

Orig Lic. Date: 2003-11-10 Medford, OR 97504

Renewal Date :2017-12-31 0

Units: 12

Management: Prestige Senior Living, L.L.C

Yes

Email: [email protected]

Other Services: MCC, ACU 18

70M243

Prestige Senior Living Beaverton Hills

4525 SW 99th Avenue

Washington

WCDAVS

Capacity: 75

Administrator: Katie Gaffney

Facility Phone: (503) 520-1350

Facility Fax: (503) 671-0511

Owner: CHP Beaverton OR Tenant CorpCounty

Orig Lic. Date: 2000-09-15 Beaverton, OR 97005

Renewal Date :2017-12-31 0

Units: 60

Management: Prestige Senior Living, LLC

Yes

Email: [email protected]

Other Services:

70A279

Prestige Senior Living Five Rivers

3500 12th St

Tillamook

Tillamook NWSDS

Capacity: 82

Administrator: David Fitting

Facility Phone: (503) 842-0918

Facility Fax: (503) 842-7077

Owner: CHP Tillamook-Five Rivers OR Tenant CorpCounty

Orig Lic. Date: 2002-06-13 Tillamook, OR 97141

Renewal Date :2017-12-31 0

Units: 64

Management: Prestige Senior Living, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 61 of 85

Page 62: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A289

Prestige Senior Living High Desert

2660 NE Mary Rose Place

Deschutes

Bend MSO

Capacity: 75

Administrator: Debra West

Facility Phone: (541) 312-2003

Facility Fax: (541) 312-2011

Owner: CHP Bend-High Desert OR Tenant Corp.County

Orig Lic. Date: 2003-07-22 Bend, OR 97701

Renewal Date :2017-12-31 0

Units: 68

Management: Prestige Senior Living, LLC

Yes

Email: [email protected]

Other Services:

70M240

Prestige Senior Living Huntington Terrace

1410 NE Cleveland

Multnomah

Mid-County

Capacity: 75

Administrator: Randall Wilson

Facility Phone: (503) 465-1404

Facility Fax: (503) 669-8896

Owner: CHP-Gresham-Huntington Terrace OR Tenant Corp.County

Orig Lic. Date: 2000-08-21 Gresham, OR 97030

Renewal Date :2017-12-31 0

Units: 66

Management: Prestige Senior Living, L.L.C

Yes

Email: [email protected]

Other Services:

70A277

Prestige Senior Living Orchard Heights

695 Orchard Heights Rd NW

Polk

Salem NWSDS

Capacity: 67

Administrator: Debra West

Facility Phone: (503) 566-9052

Facility Fax: (503) 485-2112

Owner: CHP Salem -Orchard Heights OR Tenant CorpCounty

Orig Lic. Date: 2002-05-09 Salem, OR 97304

Renewal Date :2017-12-31 0

Units: 61

Management: Prestige Senior Living, LLC

Yes

Email: [email protected]

Other Services:

50R297

Prestige Senior Living Orchard Heights Memory Care

695 Orchard Heights Rd. NW

Polk

Salem NWSDS

Capacity: 18

Administrator: Debra West

Facility Phone: (503) 566-9052

Facility Fax: (503) 485-2112

Owner: CHP Salem-Orchard Heights OR Tenant Corp.County

Orig Lic. Date: 2002-05-09 Salem, OR 97304

Renewal Date :2017-12-31 0

Units: 18

Management: Prestige Senior Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 18

70M211

Prestige Senior Living Riverwood

18321 SW Pacific Hwy

Washington

WCDAVS

Capacity: 74

Administrator: Askol Saieedi Tekantapeh

Facility Phone: (503) 925-9310

Facility Fax: (503) 925-0211

Owner: CHP Tualatin-Riverwood OR Tenant CorpCounty

Orig Lic. Date: 1999-04-09 Tualatin, OR 97062

Renewal Date :2017-12-31 0

Units: 60

Management: Prestige Senior Living, LLC

Yes

Email: [email protected]

Other Services:

70A260

Prestige Senior Living Southern Hills

4795 Skyline Rd. S.

Marion

Salem NWSDS

Capacity: 72

Administrator: Patrcia Guzman

Facility Phone: (503) 378-7499

Facility Fax: (503) 378-1481

Owner: CHP Salem-Southern Hills OR Tenant Corp.County

Orig Lic. Date: 2001-04-06 Salem, OR 97306

Renewal Date :2017-12-31 0

Units: 66

Management: Prestige Senior Living, L.L.C

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 62 of 85

Page 63: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A281

Prestige Senior Living West Hills

5595 SW West Hills Rd.

Benton

Albany

Capacity: 72

Administrator: Daniel Trout

Facility Phone: (541) 753-7136

Facility Fax: (541) 257-2008

Owner: CHP-Corvallis-West Hills OR Tenant, Inc.County

Orig Lic. Date: 2002-08-16 Corvallis, OR 97333

Renewal Date :2018-03-31 0

Units: 66

Management: Prestige Senior Living

Yes

Email: [email protected]

Other Services:

70M213

Princeton Village Assisted Living Residence

14370 SE Oregon Trail Drive

Clackamas

Milwaukie SPD

Capacity: 68

Administrator: Jennifer Thomas

Facility Phone: (503) 558-1215

Facility Fax: (503) 558-8437

Owner: ARHC PVCLAOR01 TRS, LLCCounty

Orig Lic. Date: 1999-08-16 Clackamas, OR 97015

Renewal Date :2017-03-31 0

Units: 53

Management: FM Princeton, LLC

Yes

Email: administrator@princetonvillageassistedliving.

Other Services:

70M205

Providence Benedictine Orchard House

550 S Main St.

Marion

Woodburn NWSDS

Capacity: 54

Administrator: Deana Wentworth

Facility Phone: (503) 845-2757

Facility Fax: (503) 845-2560

Owner: Providence Health & Services - OregonCounty

Orig Lic. Date: 1998-10-23 Mt. Angel, OR 97362

Renewal Date :2017-10-31 0

Units: 50

Management: Providence Health & Services - Oregon

Yes

Email: [email protected]

Other Services:

70A249

Providence Brookside Manor

1550 Brookside Dr.

Hood River

The Dalles MSO

Capacity: 20

Administrator: Jamie Hanshaw

Facility Phone: (541) 387-6370

Facility Fax: (541) 387-2728

Owner: Providence Health & Services - OregonCounty

Orig Lic. Date: 2000-11-08 Hood River, OR 97031

Renewal Date :2016-11-30 0

Units: 17

Management: Providence Health System - Oregon

Non Medicaid

Email: [email protected]

Other Services:

50A262

Providence Brookside Memory Care

1550 Brookside Dr.

Hood River

The Dalles MSO

Capacity: 24

Administrator: Jamie Hanshaw

Facility Phone: (541) 387-6370

Facility Fax: (541) 387-2728

Owner: Providence Health & Services - OregonCounty

Orig Lic. Date: 2000-11-15 Hood River, OR 97031

Renewal Date :2016-11-30 0

Units: 23

Management: Providence Health System - Oregon

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 24

50R321

Providence ElderPlace in Cully

5119 NE 57th Ave.

Multnomah

NE Portland ASO/DSO

Capacity: 42

Administrator: John Donahue

Facility Phone: (503) 215-8050

Facility Fax: (503) 215-8082

Owner: Providence Health & Services - OregonCounty

Orig Lic. Date: 2003-10-07 Portland, OR 97218

Renewal Date :2017-10-31 0

Units: 42

Management: Providence Health & Services - Oregon

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 63 of 85

Page 64: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

5MA043

Providence ElderPlace in Glendoveer

13007 NE Glisan St

Multnomah

Mid-County ASD

Capacity: 102

Administrator: Nancy Ferris

Facility Phone: (503) 215-7850

Facility Fax: (503) 215-7851

Owner: Providence Health & Services - OregonCounty

Orig Lic. Date: 1960-01-01 Portland, OR 97230

Renewal Date :2017-05-31 0

Units: 85

Management: Providence Health & Services - Oregon

Yes

Email: [email protected]

Other Services:

70A271

Providence ElderPlace in Irvington Village

420 NE Mason

Multnomah

NE Portland ASO/DSO

Capacity: 130

Administrator: Kathy Gordon

Facility Phone: (503) 546-9292

Facility Fax: (503) 335-6280

Owner: Providence Health & Services - OregonCounty

Orig Lic. Date: 2002-01-03 Portland, OR 97211

Renewal Date :2017-08-31 0

Units: 104

Management: Providence Health & Services - Oregon

Yes

Email: [email protected]

Other Services:

5MA243

Quail Park Memory Care Residences

2630 Lone Oak Way

Lane

Eugene SSO

Capacity: 79

Administrator: Cindy Herb

Facility Phone: (541) 607-5025

Facility Fax: (541) 607-5025

Owner: Laurel Court of Eugene, LLCCounty

Orig Lic. Date: 2000-04-10 Eugene, OR 97404

Renewal Date :2017-03-31 0

Units: 79

Management: Living Care Management

Yes

Email: [email protected]

Other Services: MCC, ACU 79

50M300

Quail Park Memory Care Residences of Klamath Falls

320 Jade Terrace

Klamath

Klamath Falls

Capacity: 44

Administrator: Paul "Kevin" Aruda

Facility Phone: (541) 273-7336

Facility Fax: (541) 884-1020

Owner: Quail Park of Klamath Falls Phase II, LLCCounty

Orig Lic. Date: 2015-04-01 Klamath Falls, OR 97601

Renewal Date :2017-04-30 0

Units: 28

Management: Living Care Lifestyles

Yes

Email: [email protected]

Other Services: MCC, ACU 44

50R292

Quail Park of Klamath Falls

1000 Town Center Dr.

Klamath

Klamath Falls MSO

Capacity: 43

Administrator: Bobbie Lindsey

Facility Phone: (541) 885-7250

Facility Fax: (541) 882-8882

Owner: Quail Park of Klamath Falls, LLCCounty

Orig Lic. Date: 2001-12-05 Klamath Falls OR, OR 97601

Renewal Date :2017-12-31 0

Units: 37

Management: Living Care Lifestyles

Yes

Email: [email protected]

Other Services:

70M074

Quail Run Assisted Living

2525 47th Ave SE

Linn

Albany SSO

Capacity: 137

Administrator: Crystal Well

Facility Phone: (541) 928-1122

Facility Fax: (541) 917-1393

Owner: Mennonite Home Of Albany, Inc.County

Orig Lic. Date: 1995-04-14 Albany, OR 97321

Renewal Date :2017-04-30 0

Units: 98

Management: Mennonite Home Of Albany, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 64 of 85

Page 65: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M075

Rackleff Place

655 SW 13th Ave

Clackamas

Canby SPD

Capacity: 29

Administrator: Nicolle Harold-Hollen

Facility Phone: (503) 266-9555

Facility Fax: (503) 266-9556

Owner: Canby ALF, Inc.County

Orig Lic. Date: 1990-06-18 Canby, OR 97013

Renewal Date :2017-01-31 0

Units: 25

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

70A268

Raleigh Hills Assisted Living Community

4815 SW Dogwood Ln

Washington

WCDAVS

Capacity: 90

Administrator: Lynda Brown

Facility Phone: (503) 297-3200

Facility Fax: (503) 297-5739

Owner: Raleigh Hills Management, LLCCounty

Orig Lic. Date: 2001-09-24 Portland, OR 97225

Renewal Date :2017-09-30 0

Units: 79

Management: Raleigh Hills Management, LLC

Yes

Email: [email protected]

Other Services:

50R287

Raleigh Hills Enhanced Care Community

4815 SW Dogwood Ln

Washington

WCDAVS

Capacity: 21

Administrator: Lynda Brown

Facility Phone: (503) 297-3200

Facility Fax: (503) 297-5739

Owner: Raleigh Hills Management, LLCCounty

Orig Lic. Date: 2001-09-24 Portland, OR 97225

Renewal Date :2017-09-30 0

Units: 21

Management: Raleigh Hills Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 21

70M076

Redwood Heights Retirement & Assisted Living Community

4050 12th St Cutoff SE

Marion

Salem NWSDS

Capacity: 95

Administrator: Michael Burdick

Facility Phone: (503) 540-0822

Facility Fax: (503) 361-2237

Owner: ARHC RHSALOR01 TRS, LLCCounty

Orig Lic. Date: 1997-11-21 Salem, OR 97302

Renewal Date :2017-08-31 0

Units: 80

Management: FM Redwood Heights, LLC

Yes

Email: [email protected]

Other Services:

70M220

Redwood Terrace

3111 Canal Ave

Josephine

Grants Pass MSO

Capacity: 49

Administrator: Jim Thompson

Facility Phone: (541) 471-9543

Facility Fax: (541) 479-1928

Owner: Oregon Heights, LLCCounty

Orig Lic. Date: 1996-11-18 Grants Pass, OR 97527

Renewal Date :2016-12-31 0

Units: 45

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

50A070

Regency Park Alzheimer's Care

8300 SW Barnes Rd

Washington

WCDAVS

Capacity: 49

Administrator: Serena Dumadaug

Facility Phone: (503) 292-8444

Facility Fax: (503) 292-8409

Owner: Regency Park Apartments Ltd Part.County

Orig Lic. Date: 1994-02-28 Portland, OR 97225

Renewal Date :2017-09-30 0

Units: 30

Management: Regency Park Management, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 49

Tuesday, July 05, 2016 Page 65 of 85

Page 66: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M077

Regency Park Assisted Living

8300 SW Barnes Rd

Washington

WCDAVS

Capacity: 118

Administrator: Sean Leahy

Facility Phone: (503) 292-8444

Facility Fax: (503) 292-8409

Owner: Regency Park Apartments Ltd Part.County

Orig Lic. Date: 1986-09-10 Portland, OR 97225

Renewal Date :2017-09-30 0

Units: 99

Management: Regency Park Management, LLC

Non Medicaid

Email: [email protected]

Other Services:

70A069

Regency Park Place at Corvallis

2595 Jack London St

Benton

Albany SSO

Capacity: 55

Administrator: Rochelle Collett

Facility Phone: (541) 754-5808

Facility Fax: (541) 752-8684

Owner: BD Corvallis I, LLCCounty

Orig Lic. Date: 1995-06-26 Corvallis, OR 97330

Renewal Date :2018-04-30 0

Units: 46

Management: Regency Pacific Management, LLC

Yes

Email: [email protected]

Other Services:

70M096

Regency Village at Bend

127 SE Wilson Ave

Deschutes

Bend MSO

Capacity: 88

Administrator: Deanna Bettesworth

Facility Phone: (541) 317-3544

Facility Fax: (541) 330-0121

Owner: BD Bend I, LLCCounty

Orig Lic. Date: 1995-12-08 Bend, OR 97702

Renewal Date :2018-04-30 0

Units: 65

Management: Regency Pacific Management, LLC

Yes

Email: [email protected]

Other Services:

70M207

Regency Village at Prineville

830 North Elm Street

Crook

Prineville MSO

Capacity: 57

Administrator: Michael Sheldon

Facility Phone: (541) 416-3600

Facility Fax: (541) 416-9293

Owner: BD Prineville I, LLCCounty

Orig Lic. Date: 1999-03-22 Prineville, OR 97754

Renewal Date :2018-04-30 0

Units: 47

Management: Regency Pacific Management, LLC

Yes

Email: [email protected]

Other Services:

70M038

Regency Village at Redmond

3000 SW 32nd St

Deschutes

Bend MSO

Capacity: 55

Administrator: Gerald Thomas

Facility Phone: (541) 923-5452

Facility Fax: (541) 923-0280

Owner: BD Redmond I, LLCCounty

Orig Lic. Date: 1995-02-03 Redmond, OR 97756

Renewal Date :2016-04-30 0

Units: 45

Management: Regency Pacific Management, LLC

Yes

Email: [email protected]

Other Services:

50R126

Regency Woodland

4710 Sunnyside Rd SE

Marion

Salem NWSDS

Capacity: 40

Administrator: Lisa Greer

Facility Phone: (503) 364-1355

Facility Fax: (503) 364-3666

Owner: BD Salem I, LLCCounty

Orig Lic. Date: 1988-08-01 Salem, OR 97302

Renewal Date :2016-04-30 0

Units: 36

Management: Regency Pacific Management, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 66 of 85

Page 67: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50A165

Regent at Sheldon Park, a Blue Harbor Senior Living Com

2440 Willakenzie Road

Lane

Eugene AAA

Capacity: 32

Administrator: Charisa Coxen

Facility Phone: (541) 344-1078

Facility Fax: (541) 344-1370

Owner: Sheldon Park Management LLCCounty

Orig Lic. Date: 1997-11-25 Eugene, OR 97401

Renewal Date :2016-07-31 0

Units: 16

Management: Sheldon Park Management LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 32

50A239

Regent Court, a Blue Harbor Senior Living Community

400 NW Elks Drive

Benton

Albany SSO

Capacity: 48

Administrator: Rebecca Hosner

Facility Phone: (541) 758-8000

Facility Fax: (541) 738-6543

Owner: Regent Court Management LLCCounty

Orig Lic. Date: 2000-03-15 Corvallis, OR 97330

Renewal Date :2016-07-31 0

Units: 24

Management: Regent Court Management LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 48

50R374

Revere Court of Portland

11547 NE Glisan Street

Multnomah

Mid-Mult

Capacity: 40

Administrator: Travis M. Freed

Facility Phone: (503) 255-0070

Facility Fax: (503) 257-3127

Owner: Chancellor Health Care of California X, Inc.County

Orig Lic. Date: 2011-03-01 Portland, OR 97220

Renewal Date :2017-09-30 0

Units: 29

Management: Chancellor Health Care, Inc,

Yes

Email: [email protected]

Other Services: MCC, ACU 40

70M253

Ridgeview Assisted Living Center

872 Golfview Drive

Jackson

Medford AAA

Capacity: 51

Administrator: Ingrid Johansen

Facility Phone: (541) 779-2208

Facility Fax: (541) 779-2384

Owner: Ridgeview Assisted Living Center, LLCCounty

Orig Lic. Date: 2000-11-09 Medford, OR 97504

Renewal Date :2016-11-30 0

Units: 51

Management: Ridgeview Assisted Living Center, LLC

Yes

Email: [email protected]

Other Services:

50M132

River Grove Memory Care

140 Green Lane

Lane

Eugene SSO

Capacity: 60

Administrator: Tris Legacy

Facility Phone: (541) 461-4898

Facility Fax: (541) 461-0256

Owner: River Grove Operating CompanyCounty

Orig Lic. Date: 1994-04-21 Eugene, OR 97404

Renewal Date :2017-04-30 0

Units: 60

Management: Benecia Senior Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 60

70M082

River Run Place

1155 Darlene Lane

Lane

Eugene SSO

Capacity: 56

Administrator: Joan Ziebell

Facility Phone: (541) 338-8780

Facility Fax: (541) 338-0387

Owner: River Run AID OPCO, LLCCounty

Orig Lic. Date: 1997-08-21 Eugene, OR 97401

Renewal Date :2017-07-31 0

Units: 47

Management: River Run AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 67 of 85

Page 68: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50M429

Rivera Mansions RCF

2220 SE 174th Avenue

Multnomah

Multnomah

Capacity: 6

Administrator: Airene Keppel

Facility Phone: (503) 333-2711

Facility Fax: (971) 244-5392

Owner: Rivera Mansions, LLCCounty

Orig Lic. Date: 2016-05-10 Portland, OR 97233

Renewal Date :2018-05-31 0

Units: 6

Management: Rivera Mansions, LLC

Yes

Email: [email protected]

Other Services:

50R355

Riverside Living

23500 NE Halsey St.

Multnomah

E Multnomah

Capacity: 16

Administrator: Melissa Lawrence

Facility Phone: (503) 328-9285

Facility Fax: (360) 891-7162

Owner: Riverside Living, Inc.County

Orig Lic. Date: 2008-11-24 Wood Village, OR 97060

Renewal Date :2016-11-30 0

Units: 16

Management: Riverside Living, Inc.

Yes

Email: [email protected]

Other Services:

50R202

Riverview Terrace

1970 West Harvard Avenue

Douglas

Roseburg

Capacity: 20

Administrator: Shari Bagshaw

Facility Phone: (541) 672-2500

Facility Fax: (541) 677-0489

Owner: Crown One Development LLCCounty

Orig Lic. Date: 1998-10-23 Roseburg, OR 97470

Renewal Date :2017-06-30 0

Units: 15

Management: Crown Two Development, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R375

RN Villa Care Center

401 NE 139th Avenue

Multnomah

East ADS

Capacity: 45

Administrator: Vickie Thun

Facility Phone: (503) 719-6944

Facility Fax: (503) 206-5442

Owner: RN Villa Care Center, LLCCounty

Orig Lic. Date: 2011-05-23 Portland, OR 97230

Renewal Date :2017-05-31 0

Units: 45

Management: RN Villa Care Center, LLC

Yes

Email: [email protected]

Other Services:

50R348

Rock of Ages Mennonite Home

15600 SW Rock of Ages Rd.

Yamhill

McMinnville NWSDS

Capacity: 22

Administrator: Delvin Zook

Facility Phone: (503) 472-6212

Facility Fax: (503) 472-4797

Owner: Bible Mennonite Fellowship, Inc.County

Orig Lic. Date: 2007-05-12 McMinnville, OR 97128

Renewal Date :2018-03-31 0

Units: 17

Management: Bible Mennonite Fellowship, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 22

70M054

Rogue River Place

2437 Kane St

Klamath

Klamath Falls MSO

Capacity: 43

Administrator: Donna Buick

Facility Phone: (541) 882-0440

Facility Fax: (541) 884-8576

Owner: Sage AID OPCO, LLCCounty

Orig Lic. Date: 1996-10-23 Klamath Falls, OR 97603

Renewal Date :2017-07-31 0

Units: 36

Management: Sage AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 68 of 85

Page 69: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R270

Rose Linn Vintage Place

2330 Debok Rd

Clackamas

Milwaukie SPD

Capacity: 70

Administrator: Heather Lucas

Facility Phone: (503) 655-0474

Facility Fax: (503) 655-2850

Owner: West Linn Care Center Operating Co LLCCounty

Orig Lic. Date: 2001-03-19 West Linn, OR 97068

Renewal Date :2018-07-31 0

Units: 44

Management: Benecia Senior Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 40

70M080

Rose Schnitzer Manor

6140 SW Boundary St

Multnomah

W Portland

Capacity: 180

Administrator: Glyndon Ruth Kimbrough

Facility Phone: (503) 535-4000

Facility Fax: (503) 535-4214

Owner: Robison Jewish HomeCounty

Orig Lic. Date: 1998-02-28 Portland, OR 97221

Renewal Date :2018-02-28 0

Units: 161

Management: Robison Jewish Home

Yes

Email: [email protected]

Other Services:

50R310

Rosewood Court Residential Care

4254 Weathers Street NE

Marion

Salem NWSDS

Capacity: 50

Administrator: Brian Henderson

Facility Phone: (503) 585-4602

Facility Fax: (503) 585-6002

Owner: Capri Senior Living, LLCCounty

Orig Lic. Date: 2003-02-13 Salem, OR 97301

Renewal Date :2017-02-28 0

Units: 50

Management: Capri Senior Living , LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 50

70M081

Rosewood Park Retirement & Assisted Living Residence

2405 SE Century Blvd.

Washington

WCDAVS

Capacity: 95

Administrator: Paul Silva

Facility Phone: (503) 642-2100

Facility Fax: (503) 642-1480

Owner: Rosewood Investors Group, L.L.C.County

Orig Lic. Date: 1996-01-12 Hillsboro, OR 97123

Renewal Date :2017-12-31 0

Units: 82

Management: Rosewood ALF, LLC

Yes

Email: [email protected]

Other Services:

50R290

Rosewood Specialty Care

2550 SE Century Blvd.

Washington

WCDAVS

Capacity: 48

Administrator: Angela Hernandez

Facility Phone: (503) 259-8999

Facility Fax: (503) 259-9509

Owner: Brookwood Court Assisted Living, LLCCounty

Orig Lic. Date: 2001-11-09 Hillsboro, OR 97123

Renewal Date :2017-11-30 0

Units: 48

Management: Hillsboro Care Properties, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 48

50R370

Roxy Ann Memory Community

2530 Lone Pine Road

Jackson

Medford SSO

Capacity: 16

Administrator: Tina Duncan

Facility Phone: (541) 608-7699

Facility Fax: (541) 858-7992

Owner: Roxy Ann Memory Community, LLCCounty

Orig Lic. Date: 2010-10-25 Medford, OR 97504

Renewal Date :2016-10-31 0

Units: 16

Management: Roxy Ann Memory Community, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 16

Tuesday, July 05, 2016 Page 69 of 85

Page 70: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A264

Royal Anne Assisted Living Facility

10610 SE Clay St.

Multnomah

Mid-County ADS

Capacity: 110

Administrator: Donise Sunden

Facility Phone: (503) 408-0404

Facility Fax: (503) 946-0208

Owner: PAR, LLCCounty

Orig Lic. Date: 2001-06-29 Portland, OR 97216

Renewal Date :2018-02-28 0

Units: 91

Management: Generations, LLC

Yes

Email: [email protected]

Other Services:

70A319

Royalton Place Assisted Living

5555 SE King Rd

Clackamas

Milwaukie APD

Capacity: 64

Administrator: Kristi Luce

Facility Phone: (503) 653-1854

Facility Fax: (503) 786-1670

Owner: BDC/Milwaukie, LLCCounty

Orig Lic. Date: 2012-05-01 Milwaukie, OR 97222

Renewal Date :2018-05-31 0

Units: 40

Management: Royalton Place Management, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R383

Royalton Place Memory Care

5555 SE King Rd

Clackamas

Milwaukie SPD

Capacity: 28

Administrator: Roselynn Rockwood

Facility Phone: (503) 653-1854

Facility Fax: (503) 786-1670

Owner: BDC/Milwaukie, LLCCounty

Orig Lic. Date: 2012-05-01 Milwaukie, OR 97222

Renewal Date :2018-05-31 0

Units: 19

Management: Royalton Place Management, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 28

70A314

Russellville Park West

23 SE 103rd

Multnomah

NE Portland ASO

Capacity: 120

Administrator: Meg Davidson

Facility Phone: (503) 254-5900

Facility Fax: (503) 255-7098

Owner: Russellvillle III, LLCCounty

Orig Lic. Date: 2009-05-01 Portland, OR 97216

Renewal Date :2017-05-31 0

Units: 95

Management: Leisure Care, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R360

Russellville Park West Memory Care

23 SE 103rd

Multnomah

NE Portland ASO

Capacity: 20

Administrator: Stephanie Giles

Facility Phone: (503) 254-5900

Facility Fax: (503) 255-7098

Owner: Russellvillle III, LLCCounty

Orig Lic. Date: 2009-05-01 Portland, OR 97216

Renewal Date :2017-05-31 0

Units: 16

Management: Leisure Care, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 20

70A265

Sea Aire Assisted Living

1882 N Hwy 101

Lincoln

Toledo/Lincoln SSO

Capacity: 50

Administrator: Robin Parrish

Facility Phone: (541) 547-5500

Facility Fax: (541) 547-5503

Owner: Sea Aire Assisted Living, LLCCounty

Orig Lic. Date: 2001-07-31 Yachats, OR 97498

Renewal Date :2017-12-31 0

Units: 44

Management: Sea Aire Assisted Living, LLC

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 70 of 85

Page 71: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A316

Sea View Senior Living Community

98059 Gerlach Lane

Curry

Brookings/Harbor

Capacity: 99

Administrator: Sonia Graham

Facility Phone: (541) 469-4500

Facility Fax: (541) 469-4522

Owner: Sea View Assisted Living Community, LLCCounty

Orig Lic. Date: 2010-06-01 Brookings, OR 97415

Renewal Date :2016-10-31 0

Units: 78

Management: Seasons Management, LLC

Yes

Email: [email protected]

Other Services:

50R384

Senior Haven Residential Care Facility

12140 SE Foster Road

Multnomah

Milwaukie APD

Capacity: 20

Administrator: Aristotle Paguio

Facility Phone: (971) 271-1897

Facility Fax: (503) 254-3607

Owner: Senior Haven RCF, LLCCounty

Orig Lic. Date: 2012-08-16 Portland, OR 97266

Renewal Date :2016-08-31 0

Units: 20

Management: Senior Haven RCF, LLC

Yes

Email: [email protected]

Other Services:

70M223

Settler's Park Assisted Living Community

2895 17th St.

Baker

Baker City MSO

Capacity: 56

Administrator: Jackie Wirth

Facility Phone: (541) 523-0200

Facility Fax: (541) 523-0268

Owner: LSREF Golden Ops 26 (OR) LLCCounty

Orig Lic. Date: 1999-11-05 Baker City, OR 97814

Renewal Date :2017-01-31 0

Units: 44

Management: SLH Rainier Manager, LLC

Yes

Email: [email protected]

Other Services:

50A226

Settler's Park Memory Care Community

2895 17th Street

Baker

Baker City

Capacity: 30

Administrator: Deborah S. Culley

Facility Phone: (541) 523-0200

Facility Fax: (541) 523-0268

Owner: LSREF Golden Ops 26 (OR) LLCCounty

Orig Lic. Date: 1999-11-05 Baker City, OR 97814

Renewal Date :2017-01-31 0

Units: 30

Management: SLH Rainier Manager, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 30

70A083

Sheldon Park Assisted Living, a Blue Harbor Senior Living

2440 Willakenzie Road

Lane

Eugene SSO

Capacity: 108

Administrator: Charisa Coxen

Facility Phone: (541) 344-1078

Facility Fax: (541) 344-1370

Owner: Sheldon Park Management LLCCounty

Orig Lic. Date: 1998-01-16 Eugene, OR 97401

Renewal Date :2016-07-31 0

Units: 92

Management: Sheldon Park Management LLC

Non Medicaid

Email: [email protected]

Other Services:

50M264

Sherwood Pines Residential Care

87986 Sherwood

Lane

Eugene AAA

Capacity: 16

Administrator: Danielle Evans

Facility Phone: (541) 935-0653

Facility Fax: (541) 935-4328

Owner: Sherwood Pines Residential Care, Inc.County

Orig Lic. Date: 2001-02-14 Veneta, OR 97487

Renewal Date :2017-06-30 0

Units: 12

Management: Sherwood Pines Residential Care, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 16

Tuesday, July 05, 2016 Page 71 of 85

Page 72: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A263

Shore Pines Assisted Living

93975 Ocean Way

Curry

Gold Beach MSO

Capacity: 53

Administrator: Nancy Giovannetti

Facility Phone: (541) 247-0333

Facility Fax: (541) 247-9213

Owner: Shore Pines Assisted Living, LLCCounty

Orig Lic. Date: 2001-05-02 Gold Beach, OR 97444

Renewal Date :2017-05-31 0

Units: 43

Management: Mosaic Management, Inc.

Yes

Email: [email protected]

Other Services:

70M084

Silver Creek Assisted Living Facility

703 Evergreen Rd

Marion

Woodburn NWSDS

Capacity: 41

Administrator: Trisha Irwin

Facility Phone: (503) 981-4142

Facility Fax: (503) 982-0172

Owner: FC Ranger OPS Silver Creek (OR), LLCCounty

Orig Lic. Date: 1995-06-01 Woodburn, OR 97071

Renewal Date :2017-06-30 0

Units: 32

Management: Silver Creek Care Properties, LLC

Yes

Email: [email protected]

Other Services:

50R373

Silver Creek Memory Care Community

703 Evergreen Rd.

Marion

Woodburn NWSDS

Capacity: 20

Administrator: Felicity Harvey

Facility Phone: (503) 981-4142

Facility Fax: (503) 982-0172

Owner: FC Ranger OPS Silver Creek(OR), LLCCounty

Orig Lic. Date: 2011-02-14 Woodburn, OR 97071

Renewal Date :2017-06-30 0

Units: 17

Management: Silver Creek Care Properties, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 20

50R309

Silvia & John's Residential Care

19909 SE Stark St.

Multnomah

E. Mult. ADS

Capacity: 16

Administrator: Silvia Pribeagu

Facility Phone: (503) 665-8195

Facility Fax: (503) 661-2567

Owner: Silvia & John's Residential Care, Inc.County

Orig Lic. Date: 2003-02-04 Portland, OR 97233

Renewal Date :2017-02-28 0

Units: 16

Management: Silvia & John's Residential Care, Inc.

Non Medicaid

Email: silviajohnsrcf@gmailcom

Other Services:

70M085

Skylark Assisted Living

900 Skylark Pl

Jackson

Medford

Capacity: 87

Administrator: Teresa Selby

Facility Phone: (541) 552-1713

Facility Fax: (541) 552-1058

Owner: Ashland Assisted Living, LLCCounty

Orig Lic. Date: 1997-10-24 Ashland, OR 97520

Renewal Date :2017-09-30 0

Units: 75

Management: Mission Senior Living, LLC

Yes

Email: [email protected]

Other Services:

5MA161

Skylark Memory Care

950 Skylark Place

Jackson

Medford AAA

Capacity: 32

Administrator: Ahidee Herrera

Facility Phone: (541) 552-1713

Facility Fax: (541) 552-1058

Owner: Ashland Assisted Living, LLCCounty

Orig Lic. Date: 1997-09-23 Ashland, OR 97520

Renewal Date :2017-09-30 0

Units: 20

Management: Mission Senior Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 32

Tuesday, July 05, 2016 Page 72 of 85

Page 73: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A270

Somerset Assisted Living

8360 Cason Rd

Clackamas

Milwaukie SPD

Capacity: 100

Administrator: Stephanie Deatherage

Facility Phone: (503) 723-7868

Facility Fax: (503) 655-1543

Owner: Gladstone Assisted Living LLCCounty

Orig Lic. Date: 2001-11-30 Gladstone, OR 97027

Renewal Date :2017-11-30 0

Units: 86

Management: Hawthorn Retirement Group, LLC

Yes

Email: [email protected]

Other Services:

5MA106

Southtowne Living Center

360 W 28th

Lane

Eugene AAA

Capacity: 65

Administrator: David Meisner

Facility Phone: (541) 683-3618

Facility Fax: (541) 312-0077

Owner: Eugene Southtowne Living Center, LLCCounty

Orig Lic. Date: 1991-07-01 Eugene, OR 97405

Renewal Date :2017-01-31 0

Units: 29

Management: Ageia Health Services, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 65

70M087

Spring Meadows Assisted Living Facility

36070 Pittsburg Rd

Columbia

St Helens MSO

Capacity: 44

Administrator: Scott Page

Facility Phone: (503) 397-0401

Facility Fax: (503) 397-2116

Owner: ElderservCounty

Orig Lic. Date: 1995-10-10 St Helens, OR 97051

Renewal Date :2017-09-30 0

Units: 35

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

70M088

Spring Valley Assisted Living

770 Harlow Rd

Lane

Eugene SSO

Capacity: 63

Administrator: Tracy Nelson

Facility Phone: (541) 744-2116

Facility Fax: (541) 744-0103

Owner: Cascade Living Group - Oregon, LLCCounty

Orig Lic. Date: 1993-04-01 Springfield, OR 97477

Renewal Date :2017-05-31 0

Units: 51

Management: Cascade Living Group, Inc.

Yes

Email: [email protected]

Other Services:

70A284

SpringRidge Court Assisted Living

32100 SW French Prairie Rd.

Clackamas

Milwaukie SPD

Capacity: 85

Administrator: Garth Hallman

Facility Phone: (503) 694-2800

Facility Fax: (503) 694-5124

Owner: Spring Ridge Subtenant LLCCounty

Orig Lic. Date: 2002-10-31 Wilsonville, OR 97070

Renewal Date :2018-04-30 0

Units: 70

Management: SRG Management, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R303

SpringRidge Court Memory Care

32100 SW French Prairie Rd

Clackamas

Milwaukie SPD

Capacity: 16

Administrator: Garth Hallman

Facility Phone: (503) 694-2800

Facility Fax: (503) 694-5124

Owner: Spring Ridge Subtenant LLCCounty

Orig Lic. Date: 2002-10-31 Wilsonville, OR 97070

Renewal Date :2018-04-30 0

Units: 0

Management: SRG Management, LLC

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 16

Tuesday, July 05, 2016 Page 73 of 85

Page 74: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R234

Springs at Anna Maria, The

822 Golf View Drive

Jackson

Medford

Capacity: 38

Administrator: Megan Hamilton

Facility Phone: (541) 774-1822

Facility Fax: (541) 857-0994

Owner: HSRE-Springs III at Medford AM sub-TRS, LLCCounty

Orig Lic. Date: 2000-02-14 Medford, OR 97504

Renewal Date :2016-05-31 0

Units: 29

Management: The Springs Living, LLC

Non Medicaid

Email: [email protected]

Other Services:

70A012

Springs at Carman Oaks, The

3900 SW Carman Dr

Clackamas

Milwaukie SPD

Capacity: 21

Administrator: Curchelle Ensign

Facility Phone: (503) 636-4700

Facility Fax: (503) 636-9545

Owner: HSRE-Springs II at Lake Oswego Sub-TRS, LLCCounty

Orig Lic. Date: 1996-05-24 Lake Oswego, OR 97035

Renewal Date :2016-11-30 0

Units: 17

Management: The Springs Living, LLC

Non Medicaid

Email: [email protected]

Other Services:

70M204

Springs at Clackamas Woods ALF

14314 SE Webster Rd.

Clackamas

Milwaukie SPD

Capacity: 56

Administrator: Jennifer Whalen

Facility Phone: (503) 654-3413

Facility Fax: (503) 652-5191

Owner: TSL Clack OPS, LLCCounty

Orig Lic. Date: 1999-07-19 Milwaukie, OR 97267

Renewal Date :2016-10-31 0

Units: 48

Management: The Springs Living, LLC

Yes

Email: [email protected]

Other Services:

70M219

Springs at Mill Creek, The

1201 W 10th Street

Wasco

Mid-Columbia AAA

Capacity: 65

Administrator: Toni Sly

Facility Phone: (541) 296-1303

Facility Fax: (541) 296-4051

Owner: HSRE-Springs II at the Dalles, LLPCounty

Orig Lic. Date: 1999-10-12 The Dalles, OR 97058

Renewal Date :2016-11-30 0

Units: 59

Management: The Springs Living, LLC

Yes

Email: [email protected]

Other Services:

70A276

Springs at Sherwood, The

15677 SW Oregon

Washington

WCDAVS

Capacity: 57

Administrator: Angela Jones

Facility Phone: (503) 625-9481

Facility Fax: (503) 625-1372

Owner: HSRE-Springs at Sherwood Sub-TRS, LLCCounty

Orig Lic. Date: 2002-05-03 Sherwood, OR 97140

Renewal Date :2016-11-30 0

Units: 36

Management: The Springs Living, LLC

Yes

Email: [email protected]

Other Services:

70M313

Springs at Tanasbourne II, LLC

1950 NW 192nd Avenue

Washington

Hillsboro WCDAVS

Capacity: 84

Administrator: Victor Lanna

Facility Phone: (503) 629-5500

Facility Fax: (503) 629-1515

Owner: Springs at Tanasbourne II, LLCCounty

Orig Lic. Date: 2009-04-01 Hillsboro, OR 97124

Renewal Date :2016-12-30 0

Units: 70

Management: The Springs Living, LLC

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 74 of 85

Page 75: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A300

Springs at Veranda Park, The

1641 NE Veranda Park Drive

Jackson

Medford

Capacity: 44

Administrator: Natalie Hayes

Facility Phone: (541) 494-5000

Facility Fax:

Owner: HSRE-Springs III at Medford VP Sub TRS, LLCCounty

Orig Lic. Date: 2016-02-09 Medford, OR 97504

Renewal Date :2018-02-28 0

Units: 31

Management: The Springs Living, LLC

Non Medicaid

Email: [email protected]

Other Services:

70A200

Springs at Wilsonville, The

7600 Vlahos Drive

Clackamas

Milwaukie SPD

Capacity: 85

Administrator: Dianne Selander

Facility Phone: (503) 582-9414

Facility Fax: (503) 582-9236

Owner: HSRE-Springs II at Lake Oswego Sub-TRS, LLCCounty

Orig Lic. Date: 1999-06-24 Wilsonville, OR 97070

Renewal Date :2016-11-30 0

Units: 65

Management: The Springs Living, LLC

Yes

Email: [email protected]

Other Services:

70M089

Spruce Point Assisted Living

375 9th St

Lane

Florence AAA

Capacity: 72

Administrator: Grace Hall

Facility Phone: (541) 997-6111

Facility Fax: (541) 997-5747

Owner: Spruce Point, Inc.County

Orig Lic. Date: 1995-08-01 Florence, OR 97439

Renewal Date :2017-07-31 0

Units: 65

Management: Prestige Care Inc.

Yes

Email: [email protected]

Other Services:

50R359

Spruce Point Memory Care

375 9th Street

Lane

Florence AAA

Capacity: 25

Administrator: Heidi Turner

Facility Phone: (541) 997-6111

Facility Fax: (541) 997-5747

Owner: Spruce Point, Inc.County

Orig Lic. Date: 2009-04-08 Florence, OR 97439

Renewal Date :2017-04-30 0

Units: 25

Management: Prestige Care Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 25

5MA107

St. Andrews Memory Care

7617 SE Main St

Multnomah

E County ASD

Capacity: 85

Administrator: Velita Rubino

Facility Phone: (503) 257-7946

Facility Fax: (503) 257-9221

Owner: Pacifica Senior Living, LLCCounty

Orig Lic. Date: 1988-09-01 Portland, OR 97215

Renewal Date :2018-03-31 0

Units: 60

Management: Pacifica Senior Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 85

7MU215

St. Anthony Village

3560 SE 79th Avenue

Multnomah

Mid-Mult ASD.

Capacity: 126

Administrator: Janice Mittelstaedt

Facility Phone: (503) 775-4414

Facility Fax: (503) 771-9189

Owner: St. Anthony Village Associates LPCounty

Orig Lic. Date: 1999-08-11 Portland, OR 97206

Renewal Date :2017-08-31 0

Units: 110

Management: SAGE

Yes

Email: [email protected]

Other Services: MCC, ACU 24

Tuesday, July 05, 2016 Page 75 of 85

Page 76: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A310

Stafford Assisted Living Facility, The

1200 Overlook Dr

Clackamas

Milwaukie SPD

Capacity: 16

Administrator: Thomas Cloutier

Facility Phone: (503) 636-4589

Facility Fax: (503) 636-4583

Owner: Avamere Stafford Operations, LLCCounty

Orig Lic. Date: 2008-05-01 Lake Oswego, OR 97034

Renewal Date :2016-04-30 0

Units: 12

Management: Avamere Stafford Operations, LLC

Non Medicaid

Email: [email protected]

Other Services:

70A274

Stoneybrook Assisted Living

4650 SW Hollyhock Circle

Benton

Albany SSO

Capacity: 95

Administrator: Adam Schreiber

Facility Phone: (541) 758-2026

Facility Fax: (541) 758-2862

Owner: Corvallis Assisted Living, LLCCounty

Orig Lic. Date: 2002-04-19 Corvallis, OR 97333

Renewal Date :2018-04-30 0

Units: 85

Management: Hawthorn Retirement Group, LLC

Yes

Email: [email protected]

Other Services:

70M101

Suites Assisted Living Community, The

1301 SE Parkdale Dr

Josephine

Grants Pass MSO

Capacity: 95

Administrator: Jennifer Ambeau

Facility Phone: (541) 955-9115

Facility Fax: (541) 955-9591

Owner: LSREF Golden Ops 26 (OR) LLCCounty

Orig Lic. Date: 1997-01-10 Grants Pass, OR 97526

Renewal Date :2017-01-31 0

Units: 81

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services:

70M006

Summerplace Assisted Living Community

15727 NE Russell St

Multnomah

NE Portland ASO/DSO

Capacity: 96

Administrator: Nancy Leifheit

Facility Phone: (503) 252-9361

Facility Fax: (503) 252-9405

Owner: Summerplace Assisted Living, LLCCounty

Orig Lic. Date: 1997-07-21 Portland, OR 97230

Renewal Date :2017-07-31 0

Units: 86

Management: Prestige Senior Living, LLC

Yes

Email: [email protected]

Other Services:

70M091

Summit Springs Village

133 S Church Street - PO Bx 687

Gilliam

The Dalles SPD

Capacity: 38

Administrator: Sara Riney

Facility Phone: (541) 384-2101

Facility Fax: (541) 384-2102

Owner: Summit Springs Village CorporationCounty

Orig Lic. Date: 1994-10-28 Condon, OR 97823

Renewal Date :2016-10-31 0

Units: 29

Management: Summit Springs Village Corporation

Yes

Email: [email protected]

Other Services:

50R364

Summit Springs Village MCU

120 S. Church St.

Gilliam

The Dalles AAA

Capacity: 8

Administrator: Cynthia Hess

Facility Phone: (541) 384-2101

Facility Fax: (541) 384-2102

Owner: Summit Springs Village CorporationCounty

Orig Lic. Date: 2009-12-03 Condon, OR 97823

Renewal Date :2017-12-31 0

Units: 8

Management: Summit Springs Village Corporation

Yes

Email: [email protected]

Other Services: MCC, ACU 8

Tuesday, July 05, 2016 Page 76 of 85

Page 77: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M248

Sun Terrace Hermiston

1550 NW 11th St.

Umatilla

Hermiston MSO

Capacity: 97

Administrator: Matthew Joice

Facility Phone: (541) 564-2595

Facility Fax: (541) 564-3087

Owner: Clay Davis Stroud - Oregon LLCCounty

Orig Lic. Date: 2000-10-24 Hermiston, OR 97838

Renewal Date :2016-10-31 0

Units: 80

Management: Regency Pacific Management, LLC

Yes

Email: [email protected]

Other Services:

70M045

Suncrest Place

300 Suncrest Rd

Jackson

Medford

Capacity: 40

Administrator: Jennifer Daniels

Facility Phone: (541) 512-9474

Facility Fax: (541) 512-0321

Owner: JACKSON AID OPCO, LLCCounty

Orig Lic. Date: 1996-11-08 Talent, OR 97540

Renewal Date :2017-07-31 0

Units: 36

Management: JACKSON AID OPCO, LLC

Non Medicaid

Email: [email protected]

Other Services:

50R412

Sunset Estates

281 Sunset Dr.

Malheur

Ontario

Capacity: 16

Administrator: Susanne Miller

Facility Phone: (541) 889-1115

Facility Fax: (541) 889-6662

Owner: CARE 3, LLCCounty

Orig Lic. Date: 2014-07-30 Ontario, OR 97914

Renewal Date :2016-07-31 0

Units: 16

Management: CARE 3, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 16

50R273

Suttle Care & Retirement

1601 SW 24th St.

Umatilla

Pendleton MSO

Capacity: 27

Administrator: Sarah Taylor

Facility Phone: (541) 278-0174

Facility Fax: (541) 276-0340

Owner: Suttle Care & Retirement, Inc.County

Orig Lic. Date: 2001-04-09 Pendleton, OR 97801

Renewal Date :2017-04-30 0

Units: 21

Management: Suttle Care & Retirement, Inc.

Yes

Email: [email protected]

Other Services:

70M092

Suzanne Elise Assisted Living Facility

101 Forest Drive

Clatsop

Warrenton NWSDS

Capacity: 90

Administrator: Jeanne Devitt

Facility Phone: (503) 738-0307

Facility Fax: (503) 717-8102

Owner: Forest Drive Operations, LLCCounty

Orig Lic. Date: 1997-10-30 Seaside, OR 97138

Renewal Date :2017-11-30 0

Units: 79

Management: Forest Drive Operations, LLC

Yes

Email: [email protected]

Other Services:

50R298

Sweet Bye N Bye

2480 Coral Ave NE

Marion

Salem NWSDS

Capacity: 16

Administrator: Yori Johnson

Facility Phone: (503) 362-5885

Facility Fax: (503) 362-8808

Owner: Sweet Bye N Bye AFC & RCF Facilities, Inc.County

Orig Lic. Date: 2002-05-31 Salem, OR 97305

Renewal Date :2016-10-31 0

Units: 16

Management: Sweet Bye N Bye AFC & RCF Facilities, Inc.

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 77 of 85

Page 78: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R108

Sweetbriar Villa

6135 E St.

Lane

Eugene SSO

Capacity: 39

Administrator: Jill Maher

Facility Phone: (541) 225-0200

Facility Fax: (541) 726-1173

Owner: RSL Springfield, LLCCounty

Orig Lic. Date: 1987-12-01 Springfield, OR 97478

Renewal Date :2017-05-31 0

Units: 30

Management: Radiant Senior Living, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 9

50M434

Tabor Crest II Memory Care

16050 NE Halsey

Multnomah

Multnomah

Capacity: 30

Administrator: Rodica Malos

Facility Phone: (503) 780-1112

Facility Fax:

Owner: Tabor Crest II Memory Care, LLCCounty

Orig Lic. Date: 2016-05-11 Portland, OR 97230

Renewal Date :2018-05-31 0

Units: 30

Management: Tabor Crest II Memory Care, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 30

50M109

Tabor Crest Residential Care

7430 SE Division St

Multnomah

SE Portland ASO

Capacity: 30

Administrator: Rodica Malos

Facility Phone: (503) 771-8058

Facility Fax: (503) 771-8058

Owner: Tabor Crest Residential Care, LLCCounty

Orig Lic. Date: 1980-05-07 Portland, OR 97206

Renewal Date :2016-08-31 0

Units: 27

Management: Tabor Crest Residential Care, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 30

50M110

Taft Home, The

1337 SW Washington St

Multnomah

W Portland AAA

Capacity: 80

Administrator: Karen Shenefelt

Facility Phone: (503) 223-2144

Facility Fax: (503) 241-9553

Owner: Concepts in Community Living, Inc.County

Orig Lic. Date: 1992-09-01 Portland, OR 97205

Renewal Date :2017-07-31 0

Units: 80

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

70M093

Tanner Spring Assisted Living

23000 Horizon Dr

Clackamas

Milwaukie SPD

Capacity: 72

Administrator: Jillian Bohrer

Facility Phone: (503) 655-4373

Facility Fax: (503) 655-4175

Owner: Sequoia Heights Capital PartnersCounty

Orig Lic. Date: 1998-08-14 West Linn, OR 97068

Renewal Date :2016-07-31 0

Units: 62

Management: TS Management, LLC

Yes

Email: [email protected]

Other Services:

50R366

Tanner Spring Memory Care

23000 Horizon Drive

Clackamas

Milwaukie SPD

Capacity: 44

Administrator: Anne Bardana

Facility Phone: (503) 655-4373

Facility Fax: (503) 655-4175

Owner: Sequoia Heights Capital PartnersCounty

Orig Lic. Date: 2010-01-21 West Linn, OR 97068

Renewal Date :2016-07-31 0

Units: 27

Management: TS Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 44

Tuesday, July 05, 2016 Page 78 of 85

Page 79: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70A262

Terrace at Hillside Assisted Living

440 NW Hillside Park Way

Yamhill

McMinnville NWSDS

Capacity: 68

Administrator: Denise Olson

Facility Phone: (503) 472-9534

Facility Fax: (503) 883-7499

Owner: Emeritus CorporationCounty

Orig Lic. Date: 2001-05-01 McMinnville, OR 97128

Renewal Date :2016-08-31 0

Units: 68

Management: Emeritus Corporation

Non Medicaid

Email: [email protected]

Other Services:

70A209

Terrace at Laurelhurst Village, The

3120 SE Stark

Multnomah

E Co. ASD

Capacity: 64

Administrator: Chris Madewell

Facility Phone: (503) 535-4700

Facility Fax: (503) 797-6702

Owner: Laurelhurst Operations, LLCCounty

Orig Lic. Date: 1999-03-05 Portland, OR 97214

Renewal Date :2017-06-30 0

Units: 60

Management: Laurelhurst Operations, LLC

Non Medicaid

Email: [email protected]

Other Services:

50M157

Terwilliger Plaza - Metcalf Unit

2545 SW Terwilliger Blvd

Multnomah

W Portland AAA

Capacity: 29

Administrator: Raymond Harcus

Facility Phone: (503) 808-7876

Facility Fax: (503) 299-4803

Owner: Terwilliger Plaza, Inc.County

Orig Lic. Date: 1997-04-30 Portland, OR 97201

Renewal Date :2017-04-30 0

Units: 29

Management: Terwilliger Plaza, Inc.

Yes

Email: [email protected]

Other Services:

70A246

Terwilliger Terrace Assisted Living Facility

2425 SW 6th Ave.

Multnomah

West Portland AAA

Capacity: 64

Administrator: Raymond Harcus

Facility Phone: (503) 808-7876

Facility Fax: (503) 299-4803

Owner: Terwilliger Plaza, Inc.County

Orig Lic. Date: 2000-05-17 Portland, OR 97201

Renewal Date :2016-09-30 0

Units: 44

Management: Terwilliger Plaza, Inc.

Yes

Email: [email protected]

Other Services:

50R386

Thanksgiving House

184 N 2nd St

Columbia

St Helens APD

Capacity: 7

Administrator: Dawn Nelson

Facility Phone: (503) 366-1233

Facility Fax: (971) 228-2291

Owner: Cecile MoldenCounty

Orig Lic. Date: 2012-08-26 St. Helens, OR 97051

Renewal Date :2016-08-31 0

Units: 5

Management: Cecile Molden

Yes

Email: [email protected]

Other Services:

70A097

Timberhill Place

989 NW Spruce Ave

Benton

Albany SSO

Capacity: 70

Administrator: Robin Bemrose

Facility Phone: (541) 753-1488

Facility Fax: (541) 757-3528

Owner: Vintage Investment Prop., Inc.County

Orig Lic. Date: 1995-06-28 Corvallis, OR 97330

Renewal Date :2017-06-30 0

Units: 60

Management: Vintage Investment Prop., Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 79 of 85

Page 80: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R302

Timberwood Court Specialty Care Community

2875 SE 14th Ave

Linn

Albany SSO

Capacity: 48

Administrator: Catherine Lewis

Facility Phone: (541) 967-9700

Facility Fax: (541) 924-2949

Owner: LSREF Golden Ops 26 (OR) LLCCounty

Orig Lic. Date: 2002-10-01 Albany, OR 97321

Renewal Date :2017-01-31 0

Units: 44

Management: Frontier Management, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 48

50R307

Touch of Grace, A

PO Box 165, 2156 Brookhurst St.

Jackson

Medford

Capacity: 13

Administrator: Johnny Baglietto

Facility Phone: (541) 779-1159

Facility Fax: (541) 779-1210

Owner: A Touch of Grace, LLCCounty

Orig Lic. Date: 2003-01-16 Medford, OR 97504

Renewal Date :2016-09-30 0

Units: 8

Management: A Touch of Grace, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 13

50R349

Touchmark at Mt. Bachelor Village

19800 SW Touchmark Way

Deschutes

Bend SPD

Capacity: 95

Administrator: Scott Neil

Facility Phone: (541) 383-1414

Facility Fax: (541) 383-3434

Owner: Touchmark at Mt. Bachelor Village, LLCCounty

Orig Lic. Date: 2007-07-05 Bend, OR 97702

Renewal Date :2017-07-31 0

Units: 83

Management: Touchmark Living Centers, Inc.

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 32

50R115

Turner Retirement Homes

5405 Boise Street

Marion

Salem NWSDS

Capacity: 48

Administrator: Bruce Reed

Facility Phone: (503) 743-2490

Facility Fax: (503) 743-2803

Owner: Turner Retirement Homes, Inc.County

Orig Lic. Date: 1982-01-01 Turner, OR 97392

Renewal Date :2018-01-31 0

Units: 46

Management: Turner Retirement Homes, Inc.

Yes

Email: [email protected]

Other Services:

70M098

Valley View Assisted Living

112 Valley View Dr

Grant

John Day MSO

Capacity: 42

Administrator: Stephanie Rodriguez

Facility Phone: (541) 575-3533

Facility Fax: (541) 575-2366

Owner: Valley View Investors, LLCCounty

Orig Lic. Date: 1998-02-02 John Day, OR 97845

Renewal Date :2017-12-31 0

Units: 35

Management: Ageia Health Services, LLC

Yes

Email: [email protected]

Other Services:

50R394

Valley View Memory Care

112 Valley View Drive

Grant

Bend MSO

Capacity: 10

Administrator: Stephanie Rodriquez

Facility Phone: (541) 575-3533

Facility Fax: (541) 575-5558

Owner: Valley View Investors, LLCCounty

Orig Lic. Date: 2013-08-21 John Day, OR 97845

Renewal Date :2017-08-31 0

Units: 5

Management: Ageia Health Services, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 10

Tuesday, July 05, 2016 Page 80 of 85

Page 81: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50M427

Village at Keizer Ridge Memory Care, The

1165 McGee Court

Marion

NWSDS

Capacity: 23

Administrator: Anna Palomar

Facility Phone: (503) 390-1300

Facility Fax: (503) 390-1818

Owner: VKR, LLCCounty

Orig Lic. Date: 2016-02-18 Keizer, OR 97303

Renewal Date :2018-02-28 0

Units: 22

Management: Keizer Care Properties, LLC

Yes

Email: [email protected]

Other Services: ACU 23

70M350

Village at Keizer Ridge, The

1165 McGee Court

Marion

NWSDS

Capacity: 119

Administrator: Sue Miller

Facility Phone: (503) 390-1300

Facility Fax: (503) 390-1818

Owner: VKR, LLCCounty

Orig Lic. Date: 2016-02-18 Keizer, OR 97303

Renewal Date :2018-02-28 0

Units: 104

Management: Keizer Care Properties, LLC

Yes

Email: [email protected]

Other Services:

70A267

Vineyard Heights Assisted Living & Retirement Cottages

345 SW Hill Rd.

Yamhill

McMinnville NWSDS

Capacity: 96

Administrator: Amanda Rinehart

Facility Phone: (503) 435-1000

Facility Fax: (503) 434-1599

Owner: LSREF Golden Ops 26 (OR) LLCCounty

Orig Lic. Date: 2001-09-18 McMinnville, OR 97128

Renewal Date :2017-01-31 0

Units: 80

Management: Frontier Management, LLC

Yes

Email: administrator@vineyardheightsassistedliving.

Other Services:

50R400

Vista View Mood & Memory Care

4439 Hamrick Rd

Jackson

Medford SSO

Capacity: 15

Administrator: Kathleen Howard

Facility Phone: (541) 664-2133

Facility Fax: (541) 664-1563

Owner: Kathleen HowardCounty

Orig Lic. Date: 2013-12-23 Central Point, OR 97502

Renewal Date :2017-12-31 0

Units: 15

Management: Kathleen Howard

Yes

Email: [email protected]

Other Services: MCC, ACU 15

70A322

Wallowa Valley Senior Living

605 Medical Parkway

Wallowa

Enterprise APD

Capacity: 19

Administrator: Jennifer Olson

Facility Phone: (541) 426-5311

Facility Fax: (541) 426-0411

Owner: Wallowa County Health Care DistrictCounty

Orig Lic. Date: 2013-06-27 Enterprise, OR 97828

Renewal Date :2017-06-30 0

Units: 19

Management: Marathon Enterprise, LLC

Yes

Email: [email protected]

Other Services:

50R391

Wallowa Valley Senior Living Memory Care

605 Medical Parkway

Wallowa

Enterprise APD

Capacity: 10

Administrator: Amy Ratliff

Facility Phone: (541) 426-5311

Facility Fax: (541) 426-0411

Owner: Wallowa County Health Care DistrictCounty

Orig Lic. Date: 2013-06-27 Enterprise, OR 97828

Renewal Date :2017-06-30 0

Units: 8

Management: Marathon Enterprise, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 10

Tuesday, July 05, 2016 Page 81 of 85

Page 82: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R382

Washington Gardens Memory Care

9000 SW 91st Avenue

Washington

Tigard SPD

Capacity: 48

Administrator: Landon Miller

Facility Phone: (503) 445-4363

Facility Fax:

Owner: Tigard Memory Associates, LLCCounty

Orig Lic. Date: 2011-11-10 Tigard, OR 97223

Renewal Date :2017-11-30 0

Units: 48

Management: Frontier Management, LLC

Yes

Email: administrator@washingtongardensmemoryca

Other Services: MCC, ACU 48

70A323

Waterford Grand Assisted Living

600 Waterford Way

Lane

Eugene APD

Capacity: 101

Administrator: Jennifer Roberts

Facility Phone: (541) 636-3329

Facility Fax: (541) 654-0112

Owner: BDC/EUGENE, LLCCounty

Orig Lic. Date: 2014-09-01 Eugene, OR 97401

Renewal Date :2016-09-30 0

Units: 86

Management: BPM Senior Living Company

Non Medicaid

Email: [email protected]

Other Services:

50R411

Waterford Grand Memory Care

600 Waterford Way

Lane

Eugene

Capacity: 64

Administrator: Adele Tiberius

Facility Phone: (541) 636-3329

Facility Fax: (541) 654-0112

Owner: BDC/EUGENE, LLCCounty

Orig Lic. Date: 2014-09-01 Eugene, OR 97401

Renewal Date :2016-09-30 0

Units: 64

Management: BPM Senior Living Company

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 64

50R433

Waterhouse Ridge Memory Care Community

1115 NW 158th Avenue

Washington

Beaverton APD

Capacity: 68

Administrator: Chad Stewart

Facility Phone: (503) 791-0599

Facility Fax:

Owner: Waterhouse Ridge Memory Care, LLCCounty

Orig Lic. Date: 2016-03-03 Beaverton, OR 97006

Renewal Date :2018-03-31 0

Units: 52

Management: Frontier Management, Inc., A Corporation of Co

Non Medicaid

Email: [email protected]

Other Services: ACU 68

70A102

Well Springs Assisted Living Facility

2104 W Idaho

Malheur

Ontario MSO

Capacity: 38

Administrator: Christine Hinkley

Facility Phone: (541) 889-3020

Facility Fax: (541) 889-4047

Owner: Wellsprings Operations, LLCCounty

Orig Lic. Date: 1993-05-03 Ontario, OR 97914

Renewal Date :2016-12-31 0

Units: 32

Management: Milestone Retirement Communities, LLC

Yes

Email: [email protected]

Other Services:

50R121

West Hills Village Senior Residence

5711 SW Multnomah Blvd

Multnomah

Portland W ASO

Capacity: 150

Administrator: Lindsay Schroeder

Facility Phone: (503) 245-7621

Facility Fax: (503) 245-6863

Owner: West Hills Village Limited PartnershipCounty

Orig Lic. Date: 1988-04-30 Portland, OR 97219

Renewal Date :2017-04-30 0

Units: 82

Management: West Hills Village, LP

Non Medicaid

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 82 of 85

Page 83: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R285

West Wind Court

465 4th St. SW

Coos

Coos Bay MSO

Capacity: 18

Administrator: Dominique Palmer

Facility Phone: (541) 347-9497

Facility Fax: (541) 347-5321

Owner: West Wind Court CorporationCounty

Orig Lic. Date: 2001-09-20 Bandon, OR 97411

Renewal Date :2017-04-30 0

Units: 17

Management: West Wind Court Corporation

Yes

Email: [email protected]

Other Services:

50R326

West Wind Enhanced Care

3130 Juanipero St.

Jackson

Medford AAA

Capacity: 16

Administrator: Hollie Merwin

Facility Phone: (541) 857-0700

Facility Fax: (541) 857-2887

Owner: Ashland View Manor, Inc.County

Orig Lic. Date: 2004-03-01 Medford, OR 97504

Renewal Date :2018-03-31 0

Units: 16

Management: Ashland View Manor, Inc.

Yes

Email: [email protected]

Other Services:

50R396

Whitewood Gardens

2027 SE 174th Ave.

Multnomah

E Mult ADS

Capacity: 39

Administrator: Molly McKain

Facility Phone: (503) 522-1765

Facility Fax: (503) 206-8912

Owner: Whitewood Group, LLCCounty

Orig Lic. Date: 2013-07-12 Portland, OR 97233

Renewal Date :2017-07-31 0

Units: 39

Management: Whitewood Group, LLC

Yes

Email: [email protected]

Other Services:

5MA266

Wildflower Lodge

508 16th St

Union

LaGrande MSO

Capacity: 30

Administrator: Anthony Swales

Facility Phone: (541) 663-1200

Facility Fax: (541) 962-0242

Owner: LSREF Golden Ops 14 (OR) LLCCounty

Orig Lic. Date: 2001-03-02 LaGrande, OR 97850

Renewal Date :2017-01-31 0

Units: 30

Management: SLH Rainier Manager, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 30

70M256

Wildflower Lodge Assisted Living Community

508 16th St.

Union

LaGrande MSO

Capacity: 55

Administrator: Anthony Swales

Facility Phone: (541) 663-1200

Facility Fax: (541) 663-0538

Owner: LSREF Golden Ops 14 (OR) LLCCounty

Orig Lic. Date: 2001-02-16 LaGrande, OR 97850

Renewal Date :2017-01-31 0

Units: 44

Management: SLH Rainier Manager, LLC

Yes

Email: [email protected]

Other Services:

70M103

Wiley Creek Community

5050 Mountain Fir Street

Linn

Albany SSO

Capacity: 60

Administrator: Marsha Blankenship

Facility Phone: (541) 367-1800

Facility Fax: (541) 367-1700

Owner: Mid-Valley HealthcareCounty

Orig Lic. Date: 1998-01-07 Sweet Home, OR 97386

Renewal Date :2018-01-31 0

Units: 44

Management: Aidan Health Services, Inc.

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 83 of 85

Page 84: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

50R200

Willamette Lutheran Retirement Community

7693 Wheatland Rd

Marion

Salem NWSDS

Capacity: 22

Administrator: Michele Brownlee-Deck

Facility Phone: (503) 393-1491

Facility Fax: (503) 393-7242

Owner: Willamette Lutheran Homes, Inc.County

Orig Lic. Date: 1995-10-31 Salem, OR 97308

Renewal Date :2018-01-31 0

Units: 22

Management: Willamette Lutheran Homes, Inc.

Non Medicaid

Email: [email protected]

Other Services:

70M104

Willamette Manor

176 West C Street

Linn

Albany SSO

Capacity: 46

Administrator: Jami Peterson

Facility Phone: (541) 258-8178

Facility Fax: (541) 258-8197

Owner: Willamette Manor, Inc.County

Orig Lic. Date: 1996-04-18 Lebanon, OR 97355

Renewal Date :2018-03-31 0

Units: 42

Management: Willamette Manor, Inc.

Yes

Email: [email protected]

Other Services:

50R271

Willamette View Memory Care Community

13145 SE River Rd

Clackamas

Milwaukie SPD

Capacity: 21

Administrator: Mjere Simantel

Facility Phone: (503) 353-7000

Facility Fax: (503) 652-6255

Owner: Willamette View, Inc.County

Orig Lic. Date: 2001-03-19 Portland, OR 97222

Renewal Date :2017-03-31 0

Units: 15

Management: Willamette View, Inc.

Non Medicaid

Email: [email protected]

Other Services: MCC, ACU 21

70A259

Willamette View Neighborhoods

13145 SE River Road

Clackamas

Milwaukie SPD

Capacity: 50

Administrator: Mjere Simantel

Facility Phone: (503) 353-7000

Facility Fax: (503) 652-6255

Owner: Willamette View, Inc.County

Orig Lic. Date: 2001-03-19 Portland, OR 97222

Renewal Date :2017-03-31 0

Units: 45

Management: Willamette View, Inc.

Non Medicaid

Email: [email protected]

Other Services:

50R229

Willamette View Terrace

13169 SE River Road

Clackamas

Milwaukie SPD

Capacity: 96

Administrator: Mjere Simantel

Facility Phone: (503) 652-6798

Facility Fax: (503) 652-6797

Owner: Willamette View, Inc.County

Orig Lic. Date: 1999-12-10 Portland, OR 97222

Renewal Date :2017-11-30 0

Units: 78

Management: Willamette View, Inc.

Non Medicaid

Email: [email protected]

Other Services:

70A283

Willow Creek Terrace

400 Frank Gilliam Dr.

Morrow

Pendleton MSO

Capacity: 18

Administrator: Virginia Nairns

Facility Phone: (541) 676-0004

Facility Fax: (541) 676-2901

Owner: Willow Creek Valley Assisted Living Corp.County

Orig Lic. Date: 2002-09-27 Heppner, OR 97836

Renewal Date :2016-09-30 0

Units: 16

Management: Morrow County Health District

Yes

Email: [email protected]

Other Services:

Tuesday, July 05, 2016 Page 84 of 85

Page 85: €¦ · FACILITY, ADDRESS Office of Licensing and Regulatory Oversight Licensed Assisted Living and Residential Care Facilities LICENSED CAPACITY COUNTY, LOCAL UNITS MEDICAID PROVIDER

FACILITY, ADDRESS

Office of Licensing and Regulatory Oversight

Licensed

Assisted Living and Residential Care Facilities

LICENSED CAPACITY

ADMINISTRATOR, PHONECOUNTY, LOCAL UNITS MEDICAID PROVIDER

70M043

Willow Place

1307 N College

Yamhill

McMinnville NWSDS

Capacity: 30

Administrator: Becky Hollis

Facility Phone: (503) 537-9100

Facility Fax: (503) 537-9120

Owner: Assisted Living Facilities, Inc.County

Orig Lic. Date: 1992-11-01 Newberg, OR 97132

Renewal Date :2018-01-31 0

Units: 26

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

50R125

Willson House Residential Care Facility

1625 Center St NE

Marion

Salem NWSDS

Capacity: 60

Administrator: Laura Engle

Facility Phone: (503) 585-6511

Facility Fax: (503) 585-8775

Owner: United Methodist Retirement Center Inc.County

Orig Lic. Date: 1986-07-01 Salem, OR 97301

Renewal Date :2016-07-31 0

Units: 50

Management: Concepts in Community Living, Inc.

Yes

Email: [email protected]

Other Services:

50R418

Windsong at Eola Hills

2030 Wallace Road NW

Polk

NWSDS

Capacity: 64

Administrator: Jody Burton

Facility Phone: (503) 912-4551

Facility Fax: (503) 912-4535

Owner: West Salem Memory Care, LLCCounty

Orig Lic. Date: 2015-04-08 Salem, OR 97304

Renewal Date :2017-04-30 0

Units: 56

Management: Aidan Health Services, Inc.

Yes

Email: [email protected]

Other Services: MCC, ACU 64

70M255

Woodland Heights

9355 SW McDonald St.

Washington

WCDAVS

Capacity: 55

Administrator: Linda Elder

Facility Phone: (503) 684-9696

Facility Fax: (503) 684-9892

Owner: Woodland Heights, LLCCounty

Orig Lic. Date: 2001-02-06 Tigard, OR 97224

Renewal Date :2017-06-30 0

Units: 48

Management: Woodland Heights, LLC

Yes

Email: [email protected]

Other Services:

50M174

Woods at Willowcreek, The

4398 Glencoe St NE

Marion

Salem NWSDS

Capacity: 85

Administrator: Laarni Small

Facility Phone: (503) 581-4239

Facility Fax: (503) 245-5052

Owner: Lancaster Woods Operator, LLCCounty

Orig Lic. Date: 1998-08-01 Salem, OR 97301

Renewal Date :2017-08-31 0

Units: 76

Management: The Springs Living, LLC

Yes

Email: [email protected]

Other Services: MCC, ACU 64

Statewide Licensed Capacity: 25,885Total Number of ALF's: 509

Tuesday, July 05, 2016 Page 85 of 85