MELODY COURT MEMORY CARE, LLC (NPI# 1700428687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700428687 |
Entity Type | Organization |
Organization Name | MELODY COURT MEMORY CARE, LLC |
Practice Address |
5732 Se 122nd Ave Portland OR 97236-4604 |
Practice Telephone | 5037613434 |
Mailing Telephone | 5037613434 |
Enumeration Date | 2019-10-12 |
Last Update Date | 2019-10-12 |
Authorized Official Name | MR. CALVIN DALE CRAIG II (CEO) |
Authorized Official Telephone | 5032671753 |
Authorized Official Credential | BSME |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | MELODY COURT MEMORY CARE, LLC | 5732 Se 122nd Ave, Portland, OR 97236 |
Street Address |
5732 SE 122ND AVE |
City | PORTLAND |
State | OR |
Zip Code | 97236-4604 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
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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 |
---|---|---|---|---|
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 |
---|---|---|---|---|
1518567502 | Bend Arbor, LLC | Alzheimer Center (Dementia Center) | 1290 Sw Silver Lake Blvd, Bend, OR 97702-2236 | 2020-10-28 |
1710504782 | Rsl Eugene, LLC | Alzheimer Center (Dementia Center) | 2730 Bailey Ln, Eugene, OR 97401-6923 | 2020-06-25 |
1427674852 | River Grove Operating Company, LLC | Alzheimer Center (Dementia Center) | 140 Green Ln, Eugene, OR 97404-2441 | 2020-06-22 |
1336765759 | West Salem Memory Care LLC | Alzheimer Center (Dementia Center) | 2030 Wallace Rd Nw, Salem, OR 97304-2123 | 2020-06-22 |
1205452638 | Wmc Operating Company, LLC | Alzheimer Center (Dementia Center) | 2325 N Boones Ferry Rd, Woodburn, OR 97071-9627 | 2020-06-22 |
1457977134 | Bridge Creek Investors LLC | Alzheimer Center (Dementia Center) | 1401 S 12th St, Lebanon, OR 97355-1201 | 2020-06-18 |
1013533710 | Valley View Investors LLC | Alzheimer Center (Dementia Center) | 112 Valley View Dr, John Day, OR 97845-1286 | 2020-06-18 |
1023634854 | Rsl Springfield, LLC | Alzheimer Center (Dementia Center) | 6135 E St, Springfield, OR 97478-7023 | 2020-06-17 |
1093331811 | Rsl Medford, LLC | Alzheimer Center (Dementia Center) | 1530 Poplar Dr, Medford, OR 97504-4612 | 2020-06-17 |
1760008684 | Rsl Gresham, LLC | Alzheimer Center (Dementia Center) | 1655 Ne 18th St, Gresham, OR 97030-4113 | 2020-06-17 |
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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.