Fallbrook Inc

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

372595 Issued in ME

Legal business name

FALLBROOK INC

Practice address

418 Raystreet
Portland, ME 04103

Phone

(207) 878-0788

Fax

(207) 878-7734

NPI assigned

May 27, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Robert J Feeney, ADMINISTRATOR

Title

President Administrator

Phone

(207) 878-0788

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Fallbrook Woods Doing business as

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1366600371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 RAY STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-878-0788",
            "fax_number": "207-878-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 RAYSTREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-878-0788",
            "fax_number": "207-878-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLBROOK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "FEENEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT ADMINISTRATOR",
        "authorized_official_telephone_number": "207-878-0788",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "ME",
            "license": "372595",
            "primary": true
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "ME",
            "license": "372595",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123760000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fallbrook Woods",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin Lynn Falconer, CADC
• Allison Taylor Falk
• Robert Craig Falk, RPH
• Tracey Anne Falla, OTR/L
• Fallbrook Care Operations, LLC
• Fallbrook Residential Care Facility, Inc.
• John Michael Fallon II, M.D.
• Kathleen Cole Fallon, MS LCPC NCC
• Timothy S Fallon, MD
• Megan Marie Faloon

• Alzheimer Center (Dementia Center) in Portland, ME
• Providers in Portland, ME by specialty
• Alzheimer Center (Dementia Center) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.