NPIMap

Organization Active NPI

Wallowa Valley Center for Wellness

  • Community/Behavioral Health Agency
  • Enterprise, OR
National Provider Identifier
1043249907
Registry record updated Nov 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
WALLOWA VALLEY CENTER FOR WELLNESS
Practice address
606 Medical Pkwy
Enterprise, OR 97828-5140
Phone
(541) 426-4524
Fax
(541) 426-3035
NPI assigned
Jul 2, 2006
Last updated
Nov 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2024

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

Authorized official

Name
Jim Nave
Title
Board Chair
Phone
(541) 426-4524

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

606 Medical Pkwy
Enterprise, OR 97828-5140

Mailing address

PO Box 268
Enterprise, OR 97828-0268
Phone (541) 426-4524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061120000068 OR Part B Supplier - Clinic/Group Practice 0143228536 Receives reassigned benefits from 10 practitioners
Practice locations: Enterprise, OR

National Provider Directory

National Provider Directory
Tax ID family
Wallowa Valley Center for Wellness5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

103 Highway 82
Ste D
Enterprise, OR 97828
Phone (541) 426-4524

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730592000000",
    "number": "1043249907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978280268",
            "telephone_number": "541-426-4524",
            "fax_number": "541-426-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 MEDICAL PKWY",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978285140",
            "telephone_number": "541-426-4524",
            "fax_number": "541-426-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLOWA VALLEY CENTER FOR WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A",
        "authorized_official_last_name": "NAVE",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "BOARD CHAIR",
        "authorized_official_telephone_number": "541-426-4524"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.