Columbiacare Services
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Oregon City, OR
NPI 1376784355 · NPPES record last updated Aug 20, 2010
Key facts
- NPI
- 1376784355
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- Legal business name
- COLUMBIACARE SERVICES
- Practice address
- 20025 Mossy Meadows Ave
Oregon City, OR 97045-7136 - Phone
- (541) 858-8170
- Fax
- (541) 858-8167
- NPI assigned
- Mar 20, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Robert C Beckett
- Title
- Executive Director
- Phone
- (541) 858-8170
Other NPIs on the same Medicare enrollment 32
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170420001277 | OR | Part B Supplier - Clinic/Group Practice | 6901182229 |
Receives reassigned benefits from 15 practitioners 32 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Medford, OR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Yes | ||
| Psychiatric Residential Treatment Facility | 323P00000X |
Addresses
Primary practice location
20025 Mossy Meadows Ave
Oregon City, OR 97045-7136
Mailing address
3587 Heathrow Way
Medford, OR 97504
Phone (541) 858-8170
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500615588 | Medicaid | OR |
Other names
- Mossy Meadows
Other providers in Oregon City, OR
- Jodi Linn Coleman
- Calandre D Collette
- John L Collins
- Kara Collins
- Julie Lynn Collinson
- Columbiacare Services
- Melissa E Colvin-Walters
- Community Alternative Medicine
- Complete Health Chiropractic Center, LLC
- Ruthanne Condie
All providers in Oregon City, OR · Mental Illness Community Based Residential Treatment Facility in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.