Organization Active NPI

Childerns Farm Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Corvallis, OR
National Provider Identifier
1457561524
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
CHILDERNS FARM HOME
Practice address
2820 SE Glenn St
Corvallis, OR 97333-2121
Phone
(541) 750-1121
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Joshua Taylor Copeland
Title
Lead TTL Powers
Phone
(541) 750-1121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X OR Primary

Addresses

Primary practice location

2820 SE Glenn St
Corvallis, OR 97333-2121

Mailing address

2820 SE Glenn St
Corvallis, OR 97333-2121
Phone (541) 750-1121

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457561524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 SE GLENN ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973332121",
            "telephone_number": "541-750-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 SE GLENN ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973332121",
            "telephone_number": "541-750-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDERNS FARM HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COPELAND",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "LEAD TTL POWERS",
        "authorized_official_telephone_number": "541-750-1121",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.