NPIMap

Organization Active NPI

Bob Belloni Ranch, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Coos Bay, OR
National Provider Identifier
1093040693
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
43 Issued in OR
Legal business name
BOB BELLONI RANCH, INC.
Practice address
320 Central Ave Ste 406
Coos Bay, OR 97420-2241
Phone
(541) 269-0321
NPI assigned
Oct 15, 2009
Last updated
Dec 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Authorized official

Name
Roger LanglieNPI 1730510645
Title
Executive Director
Phone
(541) 269-0321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 43 OR Primary

Addresses

Primary practice location

320 Central Ave Ste 406
Coos Bay, OR 97420-2241

Mailing address

320 Central Ave Ste 406
Coos Bay, OR 97420-2241

National Provider Directory

National Provider Directory
Tax ID family
Bob Belloni Ranch Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1093040693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE STE 406",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE STE 406",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202241",
            "telephone_number": "541-269-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOB BELLONI RANCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-15",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "LANGLIE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-269-0321"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "OR",
            "license": "43",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.