NPIMap

Organization Active NPI

Looking Glass Intensive Treatment Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Eugene, OR
National Provider Identifier
1538401906
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
LOOKING GLASS INTENSIVE TREATMENT SERVICES
Practice address
4120 Field Stone CT
Eugene, OR 97404-4082
Phone
(541) 335-9125
NPI assigned
Mar 22, 2013
Last updated
Mar 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Authorized official

Name
Monica Abe Vanderbush
Title
Residential Counselor
Phone
(541) 335-9125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU Primary

Addresses

Primary practice location

4120 Field Stone CT
Eugene, OR 97404-4082

Mailing address

4120 Field Stone CT
Eugene, OR 97404-4082

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363910400000",
    "number": "1538401906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 FIELD STONE CT",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974044082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 FIELD STONE CT",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974044082",
            "telephone_number": "541-335-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOOKING GLASS INTENSIVE TREATMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-22",
        "last_updated": "2013-03-22",
        "status": "A",
        "authorized_official_last_name": "VANDERBUSH",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "ABE",
        "authorized_official_title_or_position": "RESIDENTIAL COUNSELOR",
        "authorized_official_telephone_number": "541-335-9125"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

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