FALLBROOK INC (NPI# 1366600371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366600371 |
| Entity Type | Organization |
| Organization Name | FALLBROOK INC |
| Other Organization Name | FALLBROOK WOODS |
| Practice Address |
418 Raystreet Portland ME 04103 |
| Mailing Address |
418 Ray Street Portland ME 04103 |
| Practice Telephone | 2078780788 |
| Practice Fax Number | 2078787734 |
| Mailing Telephone | 2078780788 |
| Mailing Fax Number | 2078787734 |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |
| Authorized Official Name | MR. ROBERT J FEENEY (PRESIDENT ADMINISTRATOR) |
| Authorized Official Telephone | 2078780788 |
| Authorized Official Credential | ADMINISTRATOR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311Z00000X | Custodial Care Facility | 372595 | ME | Nursing & Custodial Care Facilities |
| Y | 311500000X | Alzheimer Center (Dementia Center) | 372595 | ME | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 123760000 | 05 |
| Other Name | Type Code |
|---|---|
| Fallbrook Woods | Doing Business As Name - Organization |
| Street Address |
418 RAYSTREET |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700428687 | Melody Court Memory Care, LLC | Alzheimer Center (Dementia Center) | 5732 Se 122nd Ave, Portland, OR 97236-4604 | 2019-10-12 |
| 1083012108 | Marcia Kerensky, Md | Alzheimer Center (Dementia Center) | 1804 Sw Pendleton St, Portland, OR 97239-2050 | 2014-12-06 |
| 1316362189 | St. Andrews Memory Care | Alzheimer Center (Dementia Center) | 7617 Se Main St, Portland, OR 97215-3075 | 2014-03-03 |
| 1730369349 | Emerson House | Alzheimer Center (Dementia Center) | 3577 Se Division St, Portland, OR 97202-1561 | 2007-11-12 |
| 1679998447 | Pinecrest Senior Villa | Alzheimer Center (Dementia Center) | 1808 Se 182nd Ave, Portland, OR 97233-5120 | 2014-03-03 |
| 1477880870 | Pcal, LLC | Alzheimer Center (Dementia Center) | 68 Devonshire St, Portland, ME 04103-4431 | 2009-11-06 |
| 1427283514 | 68 Devonshire Street | Alzheimer Center (Dementia Center) | 68 Devonshire St, Portland, ME 04103-4431 | 2009-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710440714 | Woodlands Senior Living of Madison LLC | Alzheimer Center (Dementia Center) | 141 W River Rd Ste 400, Waterville, ME 04901-5184 | 2019-04-08 |
| 1417414152 | Northbridge Avita Wells II LLC | Alzheimer Center (Dementia Center) | 86 Sanford Rd, Wells, ME 04090-5532 | 2019-03-01 |
| 1063979706 | Northbridge Avita of Stroudwater II LLC | Alzheimer Center (Dementia Center) | 113 Landing Rd, Westbrook, ME 04092-4094 | 2019-03-01 |
| 1508323247 | Northbridge Avita Brunswick II LLC | Alzheimer Center (Dementia Center) | 89 Admiral Fitch Ave, Brunswick, ME 04011-2700 | 2019-03-01 |
| 1891239679 | Avita Wells LLC | Alzheimer Center (Dementia Center) | 86 Sanford Road, Wells, ME 04090 | 2016-12-13 |
| 1992249775 | Avita Brunswick LLC | Alzheimer Center (Dementia Center) | 89 Admiral Fitch Way, Brunswick, ME 04011 | 2016-12-13 |
| 1538615224 | Woodlands Senior Living of Farmington, LLC | Alzheimer Center (Dementia Center) | 175 Knowlton Corner Rd., Farmington, ME 04938 | 2016-09-01 |
| 1689044307 | St Joseph's Memory Care, Inc. | Alzheimer Center (Dementia Center) | 426 U.S. Route 1, Frenchville, ME 04745-0469 | 2015-10-07 |
| 1225411036 | Woodlands Senior Living of Lewiston, LLC | Alzheimer Center (Dementia Center) | 45 Mollison Way, Lewiston, ME 04240 | 2015-06-30 |
| 1760816276 | Avita Stroudwater, LLC | Alzheimer Center (Dementia Center) | 320 Spring Street, Westbrook, ME 04092 | 2013-09-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on FALLBROOK INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.