New Friends of Coos Bay, LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

NEW FRIENDS OF COOS BAY, LLC

Practice address

955 Kentucky Ave
Coos Bay, OR 97420-6807

Phone

(541) 808-9730

NPI assigned

Jun 8, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carl Mason

Title

Director of Operations

Phone

(503) 826-5190

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1083281034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25260 SW PARKWAY AVE STE B",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970706627",
            "telephone_number": "503-826-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 KENTUCKY AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974206807",
            "telephone_number": "541-808-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW FRIENDS OF COOS BAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "503-826-5190"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528759",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@newfriendsofcoosbay.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "955 Kentucky Ave",
            "city": "Coos Bay",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974206807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Constance Nemec-Logan, LMT
• New Friends Memory Care, LLC
• Stacy R Newman, MD
• Austin Mitchell Newsome, LD
• Mai Nguyen
• Thanh Tri Nguyen, PHARMD
• Jean Marie Nichols

• Assisted Living Facility (Mental Illness) in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Assisted Living Facility (Mental Illness) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.