NPIMap

Organization Active NPI

Lithia Springs

  • Children's Substance Abuse Rehabilitation Facility
  • Ashland, OR
National Provider Identifier
1477708113
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
Legal business name
LITHIA SPRINGS
Practice address
695 Mistletoe Rd
Suite H
Ashland, OR 97520-9552
Phone
(541) 482-8906
Fax
(541) 779-3317
NPI assigned
Nov 21, 2008
Last updated
May 2, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY WORKS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Authorized official

Name
Connie Eidson
Title
Cfo
Phone
(541) 779-2393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X OR Primary

Addresses

Primary practice location

695 Mistletoe Rd
Suite H
Ashland, OR 97520-9552

Mailing address

201 W Main St Ste 3D
Medford, OR 97501-2744
Phone (541) 779-2393

Other identifiers 2

IdentifierTypeStateIssuer
164979MedicaidOR
127014MedicaidOR

National Provider Directory

National Provider Directory
Tax ID family
Community Works Inc4 organizations share this tax ID, including this one
Part of
Community Works Inc

Other organizations with this tax ID 3

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

Locations

695 Mistletoe Rd
Ste H
Ashland, OR 97520
Phone (541) 482-8906

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1477708113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W MAIN ST STE 3D",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012744",
            "telephone_number": "541-779-2393",
            "fax_number": "541-779-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 MISTLETOE RD",
            "address_2": "SUITE H",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975209552",
            "telephone_number": "541-482-8906",
            "fax_number": "541-779-3317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITHIA SPRINGS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY WORKS, INC.",
        "enumeration_date": "2008-11-21",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "EIDSON",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "541-779-2393"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164979",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127014",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.