Mbalmc Bend Care Properties, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MBALMC BEND CARE PROPERTIES, LLC

Practice address

20215 Powers Rd
Bend, OR 97702-3705

Phone

(541) 388-9800

Fax

(541) 388-9005

NPI assigned

Jun 18, 2020

Organization subpart

No

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

Authorized official

Name

Gregory Roderick

Title

Member

Phone

(503) 443-1818

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mt. Bachelor Assisted Living and Memory Care Doing business as

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1689290371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 SW BRIDGEPORT RD STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247790",
            "telephone_number": "503-597-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20215 POWERS RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023705",
            "telephone_number": "541-388-9800",
            "fax_number": "541-388-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBALMC BEND CARE PROPERTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-443-1818"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "527678",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "527679",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt. Bachelor Assisted Living and Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Mayer, CRM
• Tristan Lynn Mayo, R.N.
• Jessica Lundy Mazaitis, M.D.
• Milana Mazhara, NTP
• Molly Mazur
• Alexandra Demarsh McAleer
• Ian P McAlister, MD
• Mary James McAllister, DO
• Jennifer Lisa McAteer, PT, DPT
• April McCabe

• Assisted Living Facility in Bend, OR
• Providers in Bend, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.