FALLBROOK WOODS
NPI 1366600371
Alzheimer Center (Dementia Center) in Portland, ME

Q: What is Fallbrook Inc's NPI number?

The NPI number for Fallbrook Inc is 1366600371. It was assigned to this organization in the NPPES registry on May 27, 2008. The provider is doing business as Fallbrook Woods.

Q: What is Fallbrook Inc's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Q: When was this NPI record last updated?

The NPPES record for Fallbrook Inc was last updated on May 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 27, 2008CLIA 20D2245747 · Waiver

418 RAYSTREET, PORTLAND, ME 04103(207) 878-0788(207) 878-7734 Get Directions Write a Review

NPPES record last updated: May 27, 2008. Verified against the NPPES registry weekly; last sync: August 30, 2026.

On this page

About Fallbrook Woods NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FALLBROOK WOODS (NPI 1366600371) is a healthcare organization registered as an alzheimer center (dementia center) in Portland, Maine and active in the NPI registry since May 2008. The organization holds a CLIA Waiver certificate valid through December 15, 2027 and lists Robert J Feeney, President Administrator, as its authorized official.

NPPES Registry Identity

NPI1366600371

Entity TypeOrganization

Primary Taxonomy311500000X

Legal Business NameFALLBROOK INC

Location Address418 RAYSTREETPortland, ME 04103

Mailing Address418 Ray StreetPortland, ME 04103 · (207) 878-0788 · Fax (207) 878-7734

Phone(207) 878-0788

Fax(207) 878-7734

Organization SubpartNo

Authorized OfficialRobert J FeeneyPresident Administrator · (207) 878-0788

Enumeration DateMay 27, 2008

✔ NPI 1366600371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAlzheimer Center (Dementia Center)Nursing & Custodial Care Facilities

Taxonomy Code311500000X

License✔ Licensed in ME · 372595

Definition

A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.

Also ListedCustodial Care FacilityTaxonomy 311Z00000X · License 372595 (ME)

418 RAYSTREET, Portland, ME 04103

Open in Google Maps ↗

Other Names 1

Doing Business AsFallbrook Woods

Other Identifiers 1

Medicaid123760000ME

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D2245747

Fallbrook Woods Residential Care Facility · Portland, ME

Active · expires Dec 15, 2027

CLIA Number20D2245747

Laboratory TypeAssisted Living Facility

Certificate Effective DateDecember 16, 2025

Certificate Expiration DateDecember 15, 2027

Laboratory DirectorMark A. Jacobs

Laboratory Phone(207) 878-0788

Laboratory LocationFallbrook Woods Residential Care Facility60 Merrymeeting Dr, Portland, ME 04103

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 20D0088668

Fallbrook Commons · Portland, ME

Expired · Aug 31, 2026

CLIA Number20D0088668

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorLeanna Stackhouse

Laboratory Phone(207) 331-9292

Laboratory LocationFallbrook Commons91 Merrymeeting Drive, Portland, ME 04103

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fallbrook Inc's NPI number?

The NPI number for Fallbrook Inc is 1366600371. It was assigned to this organization in the NPPES registry on May 27, 2008. The provider is doing business as Fallbrook Woods.

Where is Fallbrook Inc located?

Fallbrook Inc is located at 418 Raystreet, Portland, ME 04103. The listed phone number is (207) 878-0788.

What is Fallbrook Inc's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Does Fallbrook Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D2245747) is associated with this NPI, valid through December 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fallbrook Inc was last updated on May 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.