NPIMap

Organization Active NPI

Columbiacare Services

  • Mental Illness Community Based Residential Treatment Facility
  • Coos Bay, OR
National Provider Identifier
1356438592
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
545 Issued in OR
Legal business name
COLUMBIACARE SERVICES
Practice address
1885 Thompson Rd
Coos Bay, OR 97420-2152
Phone
(541) 266-8480
Fax
(541) 266-8479
NPI assigned
Oct 9, 2006
Last updated
Mar 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Authorized official

Name
Mr. Robert C Beckett
Title
Executive Director
Phone
(541) 858-8170

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 545 OR Primary
Respite Care 385H00000X 545 OR

Addresses

Primary practice location

1885 Thompson Rd
Coos Bay, OR 97420-2152

Mailing address

1175 E Main St
1B
Medford, OR 97504-7499
Phone (541) 858-8170

Other identifiers 1

IdentifierTypeStateIssuer
312033MedicaidOR

Other names 1

  • Coos Crisis Resolution Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Oregon Regional Behavioral Services42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Practitioners & affiliated clinicians

Practitioners 53

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.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1356438592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 E MAIN ST",
            "address_2": "1B",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047499",
            "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": "1885 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202152",
            "telephone_number": "541-266-8480",
            "fax_number": "541-266-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIACARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "BECKETT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-858-8170",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": "545",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "OR",
            "license": "545",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312033",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coos Crisis Resolution Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.