December Roses, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

15-2265 Issued in OR

Legal business name

DECEMBER ROSES, LLC

Practice address

12740 SE Stark St
Building F
Portland, OR 97233-1539

Phone

(503) 257-7787

Fax

(888) 748-7787

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Norman Harris Jr., MHSA

Title

Owner/Administrator

Phone

(503) 257-7787

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Senior Helpers - Metro Portland North Doing business as

Locations

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1629449392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 SE STARK ST",
            "address_2": "BUILDING F",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "503-257-7787",
            "fax_number": "888-748-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 SE STARK ST",
            "address_2": "BUILDING F",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "503-257-7787",
            "fax_number": "888-748-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECEMBER ROSES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "NORMAN",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "503-257-7787",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OR",
            "license": "15-2265",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WA",
            "license": "60269071",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON HEALTH AUTHORITY PUBLIC HEALTH DIVISION",
            "identifier": "15-2265",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "60269071",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Helpers - Metro Portland North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Decapua, N.D.
• Emily Hyla Decarlo, MPT
• Anna Helena Decastro, LMT
• Roberto M. Decastro, M.D.
• Benjamin Ryan Deccio
• Eaba Dechasa
• Amy Margarete Dechet, M.D.
• Julie Anne Dechristopher, L.AC.
• Sophia Autumn Dechter
• Gerald Eric Deckelbaum, LCSW

• In Home Supportive Care Agency in Portland, OR
• Providers in Portland, OR by specialty
• In Home Supportive Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.