Pioneer Guest Home II, Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

300024 Issued in OR

Legal business name

PIONEER GUEST HOME II, INC

Practice address

101 E Main St
Enterprise, OR 97828-1381

Phone

(541) 426-4222

Fax

(541) 426-6550

NPI assigned

Jun 12, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Randall Perry Roddey, OWNER

Title

Licensed Administrator

Phone

(541) 263-0897

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kristin Currin, RN

  • Case Manager/Care Coordinator
  • Enterprise, OR
  • NPI 1639833205
  NPD (past)

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1235577115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978280326",
            "telephone_number": "541-426-4222",
            "fax_number": "541-426-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281381",
            "telephone_number": "541-426-4222",
            "fax_number": "541-426-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER GUEST HOME II, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "RODDEY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "PERRY",
        "authorized_official_title_or_position": "LICENSED ADMINISTRATOR",
        "authorized_official_telephone_number": "541-263-0897",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": "300024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kindra Dawn Peterson, QMHA
• Sarah Georgine Peterson, DNP,ARNP,FNP-C
• Joseph Raymond Pierri, DMD
• Makaila Jane Pinkerton
• Pioneer Guest Home
• Elizabeth Carol Powers, M.D.
• Mari Elena Prieto
• Providence Health & Services - Washington
• Tosca Rawls
• Red Cross United Drug, Inc.

• All providers in Enterprise, OR
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.