Columbiacare Services | NPI 1043410962

Key facts

NPI: 1043410962
Entity type: Organization (NPI type 2)
Primary specialty: Psychiatric Residential Treatment Facility 323P00000X
License: 07863 (OR)
Legal business name: COLUMBIACARE SERVICES
Practice address: 1945 NE 205TH Ave
Fairview, OR 97024-9622
Phone: (503) 660-8050
Fax: (503) 492-4651
NPI assigned: Jul 19, 2007
Organization subpart: No

Authorized official

Name: Mr. Robert C Beckett
Title: Executive Director
Phone: (541) 858-8170

Other NPIs on the same Medicare enrollment 32

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Columbacare Services Psychiatric Residential Treatment Facility · Brookings, OR · NPI 1518201151

Same enrollment O20170420001277
Columbia Care Services Mental Illness Community Based Residential Treatment Facility · Wilsonville, OR · NPI 1073885141

Same enrollment O20170420001277
Columbiacare Serices Mental Illness Community Based Residential Treatment Facility · Portland, OR · NPI 1336512326

Same enrollment O20170420001277
Columbiacare Serices Mental Illness Community Based Residential Treatment Facility · Medford, OR · NPI 1508218553

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Eugene, OR · NPI 1013383140

Same enrollment O20170420001277
Columbiacare Services Clinic/Center · Eugene, OR · NPI 1073065280

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Portland, OR · NPI 1114316551

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Portland, OR · NPI 1275620411

Same enrollment O20170420001277
Columbiacare Services Psychiatric Residential Treatment Facility · Milwaukie, OR · NPI 1306108691

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Oregon City, OR · NPI 1376784355

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Portland, OR · NPI 1386047132

Same enrollment O20170420001277
Columbiacare Services Psychiatric Residential Treatment Facility · Portland, OR · NPI 1386720142

Same enrollment O20170420001277
Columbiacare Services Psychiatric Residential Treatment Facility · North Bend, OR · NPI 1386787596

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Milwaukie, OR · NPI 1467685750

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Milwaukie, OR · NPI 1477832947

Same enrollment O20170420001277
Columbiacare Services Psychiatric Residential Treatment Facility · Pendleton, OR · NPI 1477974293

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Springfield, OR · NPI 1487040424

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Medford, OR · NPI 1508126368

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Milwaukie, OR · NPI 1538434675

Same enrollment O20170420001277
Columbiacare Services Psychiatric Residential Treatment Facility · Pendleton, OR · NPI 1568883254

Same enrollment O20170420001277
Columbiacare Services Psychiatric Residential Treatment Facility · Portland, OR · NPI 1588069801

Same enrollment O20170420001277
Columbiacare Services Psychiatric Residential Treatment Facility · Wilsonville, OR · NPI 1609011964

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Portland, OR · NPI 1609279595

Same enrollment O20170420001277
Columbiacare Services Psychiatric Residential Treatment Facility · Gold Beach, OR · NPI 1609963842

Same enrollment O20170420001277
Columbiacare Services Mental Illness Community Based Residential Treatment Facility · Portland, OR · NPI 1700273638

Same enrollment O20170420001277

View all 32

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Emily Dawn Bergerson Mental Health Counselor · Fairview, OR · NPI 1548990682

NPD (past)
Maryssa Marie Birch Mental Health Counselor · Fairview, OR · NPI 1679311732

NPD (past)
Sarah Bourgeois Mental Health Counselor · Fairview, OR · NPI 1144688920

NPD (past)
Melissa Brooks Mental Health Counselor · Fairview, OR · NPI 1760143069

NPD (past)
Todd Caponetto Mental Health Counselor · Fairview, OR · NPI 1245520824

NPD (past)
Lisa Cordero Mental Health Counselor · Fairview, OR · NPI 1053779835

NPD (past)
Bryan Corley Peer Specialist · Fairview, OR · NPI 1487014452

NPD (past)
Catherine Dynes Mental Health Counselor · Fairview, OR · NPI 1750410767

NPD (past)
Leanne Ensey Mental Health Counselor · Fairview, OR · NPI 1528426780

NPD (past)
Charmaine Kae Feldtman Mental Health Counselor · Tigard, OR · NPI 1558937433

NPD (past)
Jazmin Severina Flores Mental Health Counselor · Fairview, OR · NPI 1972499762

NPD (past)
Antionette Golden Mental Health Counselor · Fairview, OR · NPI 1962860742

NPD (past)
Evan Darien Gomez Villacorta Mental Health Counselor · Fairview, OR · NPI 1831073774

NPD (past)
Raquel L Graham Mental Health Counselor · Fairview, OR · NPI 1831678556

NPD (past)
Montreal Granville Mental Health Counselor · Fairview, OR · NPI 1568744811

NPD (past)
Danielle Grove Counselor · Portland, OR · NPI 1912182106

NPD (past)
Ashley Rene Hays Mental Health Counselor · Fairview, OR · NPI 1871231654

NPD (past)
Sharel Highland Mental Health Counselor · Fairview, OR · NPI 1871951657

NPD (past)
Tammy Ann Khazali Mental Health Counselor · Fairview, OR · NPI 1831808997

NPD (past)
Laroy Lackey Mental Health Counselor · Fairview, OR · NPI 1780982454

NPD (past)
Angela Lafontaine Mental Health Counselor · Fairview, OR · NPI 1538569322

NPD (past)
Stephanie Joan Larson Mental Health Counselor · Fairview, OR · NPI 1962110189

NPD (past)
Edna Leed Mental Health Counselor · Fairview, OR · NPI 1780042564

NPD (past)
Rebecca Leibham Mental Health Counselor · Fairview, OR · NPI 1407208838

NPD (past)
Alicia Loughlin Mental Health Counselor · Fairview, OR · NPI 1578961223

NPD (past)

View all 50

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OR

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20170420001277	OR	Part B Supplier - Clinic/Group Practice	6901182229	Receives reassigned benefits from 15 practitioners 32 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Medford, OR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Illness Community Based Residential Treatment Facility	320800000X	07863	OR
Psychiatric Residential Treatment Facility	323P00000X	07863	OR	Yes

Addresses

Primary practice location

1945 NE 205TH Ave
Fairview, OR 97024-9622

Mailing address

3587 Heathrow Way
Medford, OR 97504
Phone (541) 858-8170

Other identifiers

Identifier	Type	State	Issuer
517872	Other	OR	PROVIDER NUMBER SERVICE
274258	Medicaid	OR

Other names

Fairview Firs Other name

Other providers in Fairview, OR

All providers in Fairview, OR · Psychiatric Residential Treatment Facility in Oregon

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.