NPIMap

Organization Active NPI

Program Design Concepts, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Bend, OR
National Provider Identifier
1821544685
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
0224 Issued in OR
Legal business name
PROGRAM DESIGN CONCEPTS, INC
Practice address
22022 Nelson Rd
Bend, OR 97701-9790
Phone
(541) 318-1676
Fax
(541) 318-1709
NPI assigned
Aug 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Authorized official

Name
Mr. Deveney Joy Marshall
Title
Associate Director
Phone
(541) 318-1676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 0224 OR Primary

Addresses

Primary practice location

22022 Nelson Rd
Bend, OR 97701-9790

Mailing address

PO Box 6454
Bend, OR 97708-6454
Phone (541) 318-1676

Other names 1

  • New Leaf Academy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1821544685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6454",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086454",
            "telephone_number": "541-318-1676",
            "fax_number": "541-318-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22022 NELSON RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019790",
            "telephone_number": "541-318-1676",
            "fax_number": "541-318-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRAM DESIGN CONCEPTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "DEVENEY",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "541-318-1676",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": "0224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Leaf Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.