Advanced Disability Services, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

90025176060909D Issued in OR

Legal business name

ADVANCED DISABILITY SERVICES, INC

Practice address

7020 SW Country Club Dr
Corvallis, OR 97333-2615

Phone

(541) 929-7454

NPI assigned

Sep 10, 2009

Last updated

Sep 10, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jason Bratsouleas

Title

Owner/Ceo

Phone

(541) 929-7454

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1083947972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 SW COUNTRY CLUB DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973332615",
            "telephone_number": "541-929-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7020 SW COUNTRY CLUB DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973332615",
            "telephone_number": "541-929-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DISABILITY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-10",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "BRATSOULEAS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "541-929-7454"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OR",
            "license": "90025176060909D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adetola Samson Adebola, MD
• Bikash Adhikari
• Phyllis E Adjei
• Benjamin Andrew Adler, MD
• Darcy Adsit
• Jerrell Taituave Afalava
• Megan Jo Eyler Afshar, DPT
• Queenie Love Love Agbayani
• Deidma Ann Agee-Brockmann, QMHA
• Branden Agee

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.