NPIMap

Organization Active NPI

Siskiyou Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Grants Pass, OR
National Provider Identifier
1306500574
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SISKIYOU COMMUNITY HEALTH CENTER INC
Practice address
6741 Monument Dr
Grants Pass, OR 97526-8536
Phone
(541) 472-4777
Fax
(541) 471-1439
NPI assigned
Oct 25, 2021
Organization subpart
Yes
Parent organization
SISKIYOU COMMUNITY HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Authorized official

Name
Eric Van Houten, MSW, MBA
Title
Ceo
Phone
(541) 472-4777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

6741 Monument Dr
Grants Pass, OR 97526-8536

Mailing address

1701 NW Hawthorne Ave
Grants Pass, OR 97526-1051
Phone (541) 472-4777

Other identifiers 1

IdentifierTypeStateIssuer
127725MedicaidOR

Other names 1

  • North Valley High School SBHC Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2246862North Valley High School6741 Monument Dr, Grants Pass, OR 97526Certificate of waiverDec 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Siskiyou Community HLTH13 organizations share this tax ID, including this one
Part of
Siskiyou Community HLTH

Other organizations with this tax ID 12

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

Locations

6741 Monument Dr
Grants Pass, OR 97526
Phone (541) 479-3388

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1306500574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261051",
            "telephone_number": "541-472-4777",
            "fax_number": "541-471-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6741 MONUMENT DR",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975268536",
            "telephone_number": "541-472-4777",
            "fax_number": "541-471-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISKIYOU COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SISKIYOU COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2021-10-25",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "VAN HOUTEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-472-4777",
        "authorized_official_credential": "MSW, MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127725",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Valley High School SBHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.