Dallas Mennonite Retirement Community, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

800268 Issued in OR

Legal business name

DALLAS MENNONITE RETIREMENT COMMUNITY, INC.

Practice address

377 NW Jasper St
Dallas, OR 97338-1279

Phone

(503) 623-5581

Fax

(503) 623-2901

NPI assigned

Nov 29, 2005

Last updated

Dec 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gerald J. McMullin

Title

Board Chair

Phone

(503) 623-3843

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Dallas Health Care Center L L C2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Dallas Health Care Center L L C

  dba Dallas Retirement Village Health Center

  • Skilled Nursing Facility
  • Dallas, OR
  • NPI 1902140171
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Dallas Health Care Center L L C

  dba Dallas Retirement Village Health Center

  • Skilled Nursing Facility
  • Dallas, OR
  • NPI 1902140171
  NPPES parent name

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1598749038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 NW JASPER ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381279",
            "telephone_number": "503-623-5581",
            "fax_number": "503-623-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 NW JASPER ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381279",
            "telephone_number": "503-623-5581",
            "fax_number": "503-623-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS MENNONITE RETIREMENT COMMUNITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "MCMULLIN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "BOARD CHAIR",
        "authorized_official_telephone_number": "503-623-3843",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": "800268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800268",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassi June Ann Crawford
• Jessica Cecilia Cromwell
• Inge Daeschel, R.D., L.D.
• Dallas Family Medicine LLC
• Dallas Health Care Center L L C (Dallas Retirement Village Health Center)
• Dallas Oregon Emergency Physicians LLC
• Dallas School District
• Victoria Roth Darling, MS
• Marlisha Darr, QMHP
• Darrington Physical Therapy LLC

• Skilled Nursing Facility in Dallas, OR
• Providers in Dallas, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.