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DALLAS RETIREMENT VILLAGE HEALTH CENTER
NPI 1902140171
Skilled Nursing Facility in Dallas, OR

Active since November 12, 2012CLIA Certified · 2 labs
1/5
Overall Rating
377 NW JASPER ST, DALLAS, OR 97338(503) 623-5581(503) 623-2901 Get Directions Write a Review

NPPES record last updated: June 3, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 28, 2019, Apr 30, 2018 (2 updates tracked since 2018).

About Dallas Retirement Village Health Center NPPES

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

DALLAS RETIREMENT VILLAGE HEALTH CENTER (NPI 1902140171) is a healthcare organization registered as a skilled nursing facility in Dallas, Oregon and active in the NPI registry since November 2012. The organization holds 2 active CLIA laboratory certificates and lists Joy A Haverkost, Director Of Business Services, as its authorized official.

NPPES Registry Identity

NPI1902140171
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameDALLAS HEALTH CARE CENTER L L C
Location Address377 NW JASPER STDallas, OR 97338-1279
Mailing Address377 Nw Jasper StDallas, OR 97338-1279 · (503) 623-5581 · Fax (503) 623-2901
Phone(503) 623-5581
Fax(503) 623-2901
Organization SubpartYesParent: Dallas Mennonite Retirement Community, Inc.
Authorized OfficialJoy A HaverkostDirector Of Business Services · (503) 391-7549
Enumeration DateNovember 12, 2012
Last NPPES UpdateJune 3, 20222 updates tracked since enumeration
NPPES CertifiedJune 3, 2022
✔ NPI 1902140171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
377 NW JASPER ST, Dallas, OR 97338
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Other Names 1

Doing Business AsDallas Retirement Village Health Center

Other Identifiers 1

Medicaid500653791OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

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 38D0687093

Dallas Retirement Village · Dallas, OR
Active · expires Dec 31, 2027
CLIA Number38D0687093
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJanuary 1, 2026
Certificate Expiration DateDecember 31, 2027
Laboratory DirectorAngela Mccallum
Laboratory Phone(503) 623-5581
Laboratory LocationDallas Retirement Village377 NW Jasper St Attn Mary Driscoll, Dallas, OR 97338
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 38D2246519

Dallas Retirement Village · Dallas, OR
Active · expires Dec 26, 2027
CLIA Number38D2246519
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 27, 2025
Certificate Expiration DateDecember 26, 2027
Laboratory DirectorKanoe Creech
Laboratory Phone(503) 831-0214
Laboratory LocationDallas Retirement Village340 NW Brentwood Ave, Dallas, OR 97338
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Dallas Retirement Village Health Center (CMS certification number 385207), from CMS Care Compare.

Dallas Retirement Village Health Center

Nursing home · Dallas, OR
1/5 CMS Overall Rating
OwnershipNon profit - Corporation
CMS Certification Number385207
Certified Beds121 beds103 residents per day on average
Medicare & Medicaid Participant SinceSeptember 12, 1989
Resident & Family CouncilResident and family councils
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
Long-Stay Quality
Quality of care delivered to long-term residents.
2/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
2/5
Staffing
Based on nursing staff hours relative to resident needs.
4/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
145.33
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 3.01 · LPN 1.17 · RN 0.55
4.73 hrs per resident per day
Weekend Nurse Staffing
4.22 hrs per resident per day
Physical Therapist Staffing
0.08 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
56%
Registered Nurse Turnover
35.7%
Administrators Who Have Left
In the past year.
3
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
6
Substantiated Complaints
21
Fines
1 totaling $657.80
Medicare Payment Denials
0
Total Penalties
1
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMOTHY RYAN JAMAR
Physical Therapist
377 NW JASPER ST
DALLAS, OR 97338
Polk County (503) 623-5581
PEGGY ANN CHUPP
Physical Medicine & Rehabilitation
377 NW JASPER ST
DALLAS, OR 97338
Polk County (503) 623-5581
DR. LEA CAMILLE DOMINGO KEENANTASKER DPT
Physical Therapist
377 NW JASPER ST
DALLAS, OR 97338
Polk County (503) 623-5581
HEALTHPRO HERITAGE REHAB & FITNESS, LLC
Physical Therapist
377 NW JASPER ST
DALLAS, OR 97338
Polk County (864) 244-3626
ERIC TAYLOR SLP
Speech-Language Pathologist
377 NW JASPER ST
DALLAS, OR 97338
Polk County (503) 623-5581
MS. TERI MARIE
Registered Nurse (Gerontology)
377 NW JASPER ST
DALLAS, OR 97338
Polk County (503) 623-5581
DALLAS MENNONITE RETIREMENT COMMUNITY, INC.
Skilled Nursing Facility
377 NW JASPER ST
DALLAS, OR 97338
Polk County (503) 623-5581
RAFAEL CISNEROS
Physical Therapy Assistant
377 NW JASPER ST
DALLAS, OR 97338
Polk County (913) 953-1220

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 Dallas Health Care Center L L C's NPI number?

The NPI number for Dallas Health Care Center L L C is 1902140171. It was assigned to this organization in the NPPES registry on November 12, 2012. The provider is doing business as Dallas Retirement Village Health Center.

Where is Dallas Health Care Center L L C located?

Dallas Health Care Center L L C is located at 377 NW Jasper St, Dallas, OR 97338. The listed phone number is (503) 623-5581.

What is Dallas Health Care Center L L C's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Dallas Health Care Center L L C hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

Is Dallas Health Care Center L L C a Medicare-certified nursing home?

Yes. Dallas Retirement Village Health Center is a Medicare-certified nursing home with 121 certified beds.

What quality rating does Dallas Health Care Center L L C have?

CMS rates Dallas Retirement Village Health Center 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Dallas Health Care Center L L C accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Dallas Health Care Center L L C as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dallas Health Care Center L L C was last updated on June 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.