1. Home
  2. Directory
  3. Oregon
  4. Bandon
  5. Residential Treatment Facility Intellectual And Or Developmental Disabilities
  6. NPI Profile

BLUE DIAMOND ESTATES
NPI 1962090951
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Bandon, OR

Active since January 05, 2021
87326 MCTIMMONS LN, BANDON, OR 97411(541) 217-4006(541) 347-7555 Get Directions Write a Review

NPPES record last updated: January 5, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Blue Diamond Estates NPPES

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

BLUE DIAMOND ESTATES (NPI 1962090951) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Bandon, Oregon and active in the NPI registry since January 2021. The organization lists Mary Johnson, Qmha, as its authorized official.

NPPES Registry Identity

NPI1962090951
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameBLUE DIAMOND ESTATES
Location Address87326 MCTIMMONS LNBandon, OR 97411-8285
Mailing Address87326 Mctimmons LnBandon, OR 97411-8285 · (541) 217-4006
Phone(541) 217-4006
Fax(541) 347-7555
Organization SubpartNo
Authorized OfficialMary JohnsonQmha · (541) 751-5040
Enumeration DateJanuary 5, 2021
NPPES CertifiedJanuary 5, 2021
✔ NPI 1962090951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
87326 MCTIMMONS LN, Bandon, OR 97411
Open in Google Maps ↗

Other Identifiers 1

Medicaid527511OR

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 Blue Diamond Estates's NPI number?

The NPI number for Blue Diamond Estates is 1962090951. It was assigned to this organization in the NPPES registry on January 5, 2021.

Where is Blue Diamond Estates located?

Blue Diamond Estates is located at 87326 Mctimmons Ln, Bandon, OR 97411. The listed phone number is (541) 217-4006.

What is Blue Diamond Estates's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Blue Diamond Estates was last updated on January 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.