NPIMap

Organization Active NPI

G Street Integrated Health

Doing business as Kaitlin's House

  • Children's Substance Abuse Rehabilitation Facility
  • Springfield, OR
National Provider Identifier
1295450898
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
Legal business name
G STREET INTEGRATED HEALTH
Doing business as
Kaitlin's House
Practice address
1601 I St
Springfield, OR 97477-4163
Phone
(541) 735-9420
Fax
(541) 747-9870
NPI assigned
Oct 5, 2022
Last updated
Oct 5, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
G STREET INTEGRATED HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Jennifer Ocker
Title
Ceo
Phone
(541) 735-9421

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X NU
Children's Substance Abuse Rehabilitation Facility 3245S0500X NU Primary

Addresses

Primary practice location

1601 I St
Springfield, OR 97477-4163

Mailing address

PO Box 163
Springfield, OR 97477-0024
Phone (541) 735-9420

Other names 1

  • Kaitlin's House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
G Street Integrated Health5 organizations share this tax ID, including this one
Part of
G Street Integrated Health

Other organizations with this tax ID 4

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

Locations

1601 I St
Springfield, OR 97477
Phone (541) 735-9420

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1295450898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974770024",
            "telephone_number": "541-735-9420",
            "fax_number": "541-747-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 I ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774163",
            "telephone_number": "541-735-9420",
            "fax_number": "541-747-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G STREET INTEGRATED HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "G STREET INTEGRATED HEALTH",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "OCKER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-735-9421"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaitlin's House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.