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Columbiacare Services Inc

Organization Active NPI Psychiatric Residential Treatment Facility · Junction City, OR

NPI 1124780184 · NPPES record last updated Oct 7, 2021

Key facts

NPI
1124780184
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric Residential Treatment Facility 323P00000X
Legal business name
COLUMBIACARE SERVICES INC
Practice address
29398 Recovery Way # 2
Junction City, OR 97448-8447
Phone
(541) 858-8170
Fax
(541) 858-8167
NPI assigned
Oct 7, 2021
Organization subpart
No

Authorized official

Name
Michael Sewitsky
Title
Finance Director
Phone
(541) 858-8170

Corporate family (same tax ID) 41

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

View all 41

National Provider Directory

Tax ID family
Columbiacare Services Inc (42 organizations share this tax ID)

Locations

29398 Recovery Way
#2
Junction City, OR 97448

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Yes

Addresses

Primary practice location

29398 Recovery Way # 2
Junction City, OR 97448-8447

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 858-8170

Other names

  • Madrone Ridge Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 7, 2021.

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1124780184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HEATHROW WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044004",
            "telephone_number": "541-858-8170",
            "fax_number": "541-858-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29398 RECOVERY WAY # 2",
            "city": "JUNCTION CITY",
            "state": "OR",
            "postal_code": "974488447",
            "telephone_number": "541-858-8170",
            "fax_number": "541-858-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIACARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "SEWITSKY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "541-858-8170"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madrone Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Junction City, OR

All providers in Junction City, OR · Psychiatric Residential Treatment Facility in Oregon

Sources for this page

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