NEW FRIENDS OF COOS BAY, LLC
NPI 1083281034
Assisted Living Facility - Assisted Living, Mental Illness in Coos Bay, OR

NPI Status: Active since June 08, 2021

Contact Information

955 KENTUCKY AVE
COOS BAY, OR
ZIP 97420
Phone: (541) 808-9730

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  • Organization
  • Assisted Living Facility
  • Assisted Living, Mental Illness
  • CLIA Number: 38D2252243
  • CLIA Cert. Type: Other - MEMORY CARE FACILITY
  • CLIA Exp. Date: 02-08-2026

About NEW FRIENDS OF COOS BAY, LLC

This page provides the complete NPI Profile along with additional information for New Friends Of Coos Bay, Llc, a provider established in Coos Bay, Oregon operating as a Assisted Living Facility, focusing in assisted living, mental illness . The healthcare provider is registered in the NPI registry with number 1083281034 assigned on June 2021. The practitioner's primary taxonomy code is 3104A0625X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Carl Mason (Director Of Operations)

NPI
1083281034
Provider Name
NEW FRIENDS OF COOS BAY, LLC
Entity Type
Organization
Location Address
955 KENTUCKY AVE COOS BAY, OR 97420
Location Phone
(541) 808-9730
Mailing Address
25260 SW PARKWAY AVE STE B WILSONVILLE, OR 97070
Mailing Phone
(503) 826-5190
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-08-2021
Last Update Date
06-08-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility Assisted Living, Mental Illness

Taxonomy Code
3104A0625X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CARL MASON

Authorized Official Title
DIRECTOR OF OPERATIONS
Authorized Official Phone
(503) 826-5190

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
528759MEDICAID (05)OR 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
38D2252243
Facility Type
Other - MEMORY CARE FACILITY
Certificate Effective Date
February 09, 2024
Certificate Expiration Date
February 08, 2026
Laboratory Director
KIM PRUITT
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to New Friends Of Coos Bay, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for NEW FRIENDS OF COOS BAY, LLC

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1083281034
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2016348206
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 6 + 3 + 4 + 8 + 2 + 0 + 6 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1083281034 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083281034, enumerated in the NPI registry as an "organization" on June 08, 2021

The provider is located at 955 Kentucky Ave Coos Bay, Or 97420 and the phone number is (541) 808-9730

This medical organization specializes in Assisted Living Facility with taxonomy code 3104A0625X with a focus in Assisted Living, Mental Illness

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 38D2252243 for a "other - memory care facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on June 08, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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