NPIMap

Organization Active NPI

Wallowa Valley Center for Wellness

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Enterprise, OR
National Provider Identifier
1093952996
Registry record updated Nov 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
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
Jan 14, 2009
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
Chantay JettNPI 1033536560
Title
Executive Director
Phone
(541) 426-4524

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 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

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

207 SW 1st St
Enterprise, OR 97828
Phone (541) 426-0801

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730592000000",
    "number": "1093952996",
    "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": "2009-01-14",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A",
        "authorized_official_last_name": "JETT",
        "authorized_official_first_name": "CHANTAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-426-4524"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.