NPIMap

Organization Active NPI

Coos County Correctional Treatment Center

  • Addiction (Substance Use Disorder) Counselor
  • North Bend, OR
National Provider Identifier
1538320528
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
COOS COUNTY CORRECTIONAL TREATMENT CENTER
Practice address
1975 McPherson St
North Bend, OR 97459-3482
Phone
(541) 756-2020
Fax
(541) 756-4401
NPI assigned
Jun 23, 2008
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Kelly Church
Title
Business Manager
Phone
(541) 396-3173

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X OR Primary

Addresses

Primary practice location

1975 McPherson St
North Bend, OR 97459-3482

Mailing address

PO Box 849
North Bend, OR 97459-0070
Phone (541) 756-2020

National Provider Directory

National Provider Directory
Tax ID family
Coos County Health Depa5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1975 McPherson St
North Bend, OR 97459
Phone (541) 756-2020

Practitioners & affiliated clinicians

Practitioners 2

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": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1538320528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974590070",
            "telephone_number": "541-756-2020",
            "fax_number": "541-756-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 MCPHERSON ST",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593482",
            "telephone_number": "541-756-2020",
            "fax_number": "541-756-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOS COUNTY CORRECTIONAL TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "541-396-3173"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.