Organization Active NPI

Fallbrook Care Operations, LLC

  • Skilled Nursing Facility
  • Portland, ME
National Provider Identifier
1649026832
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FALLBROOK CARE OPERATIONS, LLC
Practice address
91 Merrymeeting Dr
Portland, ME 04103-3959
Phone
(207) 786-3554
NPI assigned
Apr 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Mr. Glen Cyr
Title
Senior Vice President of Finance
Phone
(207) 786-3554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

91 Merrymeeting Dr
Portland, ME 04103-3959

Mailing address

PO Box 1408
Lewiston, ME 04243-1408
Phone (207) 786-3554

Other names 1

  • Fallbrook Commons Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240905004418 ME Part A Provider - Skilled Nursing Facility 0244770139 Practice locations: Portland, ME

Skilled nursing facility certification: CCN 205134

Legal name
FALLBROOK CARE OPERATIONS, LLC
Doing business as
FALLBROOK COMMONS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1993
Last certification
Aug 22, 2024
Beds
102
Ownership / control type
Other Nonprofit
Most recent change of ownership
Sep 13, 2024
Organization structure
LLCProprietary
Enrollment address
91 Merrymeeting Dr
Portland, ME 04103-3959
Nursing home name
FALLBROOK COMMONS
Affiliated entity
NORTH COUNTRY ASSOCIATES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fallbrook CommonsCCN 205134
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Jan 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10297.0 residents per day on average
Chain
North Country Associates9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0088668Fallbrook Commons91 Merrymeeting Drive, Portland, ME 04103Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

91 Merrymeeting Dr
Portland, ME 04103
Phone (207) 331-9292

Ownership & related parties

All disclosed owners & managing parties 30

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Daniel Maguire Individual 5% Or Greater Indirect Ownership Interest Sep 13, 2024 10%
Adp of the SNF Dec 30, 2024
Fallbrook Care Operations, LLC Organization, Portland, ME LLC Operational/Managerial Control Dec 2, 2024
Adp of the SNF Dec 2, 2024
Joel Rogers Individual Operational/Managerial Control Oct 31, 2024
Adp of the SNF Dec 30, 2024
Glen G Cyr Individual Operational/Managerial Control Oct 31, 2024
Adp of the SNF Dec 2, 2024
Laundry French Construction Company LLC Organization, Scarborough, ME Corporation, LLC 5% Or Greater Indirect Ownership Interest Sep 13, 2024 8.3%
Adp of the SNF Sep 13, 2024
Michael C Tyler Individual 5% Or Greater Indirect Ownership Interest Sep 13, 2024 10%
Adp of the SNF Oct 31, 2024
Paul Harstad Individual 5% Or Greater Indirect Ownership Interest Sep 13, 2024 4.43%
Richard T Marino Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
DLF-MCT Equity Partners, LLC Organization, Portland, ME Corporation, LLC 5% Or Greater Indirect Ownership Interest Sep 13, 2024 0.28%
Mary Jane Richards Individual Operational/Managerial Control Oct 31, 2024
Individual Indirect Ownership Interest Sep 13, 2024 2.77%
WR Realty LLC Organization, Bangor, ME LLC 5% Or Greater Indirect Ownership Interest Sep 13, 2024 11.07%
WR Realty Organization, Bangor, ME Corporation, LLC 5% Or Greater Indirect Ownership Interest Sep 13, 2024 11.07%
Adp of the SNF Sep 13, 2024
Individual Indirect Ownership Interest Sep 13, 2024 1.66%
John C Orestis Individual 5% Or Greater Indirect Ownership Interest Sep 13, 2024 50%
Adp of the SNF Dec 2, 2024
Denis Landry Individual 5% Or Greater Indirect Ownership Interest Sep 13, 2024 5.54%
David Friedman Individual 5% Or Greater Indirect Ownership Interest Sep 13, 2024 30%
Adp of the SNF Dec 30, 2024
Stroudwater Sr Partners LLC Organization, Portland, ME Corporation, LLC 5% Or Greater Indirect Ownership Interest Sep 13, 2024 5.81%
Individual Indirect Ownership Interest Sep 13, 2024 1.11%
SPDB LLC Organization, Portland, ME Corporation, LLC 5% Or Greater Indirect Ownership Interest Sep 13, 2024 0.89%
Botein & Company Organization, Brookline, MA Holding company 5% Or Greater Indirect Ownership Interest Sep 13, 2024 2.77%
Individual Indirect Ownership Interest Sep 13, 2024 1.11%
Poncher Investment Partners Organization, Los Angeles, CA Corporation 5% Or Greater Indirect Ownership Interest Sep 13, 2024 3.88%
North South Organization, Brunswick, ME LLC 5% Or Greater Indirect Ownership Interest Sep 13, 2024 2.77%
Knight Investment Company LLC Organization, Los Angeles, CA LLC 5% Or Greater Indirect Ownership Interest Sep 13, 2024 2.21%
Individual Indirect Ownership Interest Sep 13, 2024 2.21%
FB Portland LLC Organization, Scarborough, ME Corporation, LLC 5% Or Greater Indirect Ownership Interest Sep 13, 2024 5.54%
Adp of the SNF Sep 13, 2024
Individual Indirect Ownership Interest Sep 13, 2024 0.55%
Great River Productions Profit Sharing Plan Organization, Los Angeles, CA Corporation 5% Or Greater Indirect Ownership Interest Sep 13, 2024 1.66%
Individual Indirect Ownership Interest Sep 13, 2024 4.43%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1649026832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1408",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042431408",
            "telephone_number": "207-786-3554",
            "fax_number": "207-786-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MERRYMEETING DR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033959",
            "telephone_number": "207-786-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLBROOK CARE OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-28",
        "status": "A",
        "authorized_official_last_name": "CYR",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "207-786-3554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fallbrook Commons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.