NPIMap

Organization Active NPI

Innervision Health Services, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Salem, OR
National Provider Identifier
1548022601
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
INNERVISION HEALTH SERVICES, INC
Practice address
681 Cottage St NE
Salem, OR 97301-2419
Phone
(336) 314-7105
NPI assigned
Jan 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Ebony Dechelle WigginsNPI 1124849971
Title
Director
Phone
(336) 314-7105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X
Adult Mental Health Clinic/Center 261QM0850X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

681 Cottage St NE
Salem, OR 97301-2419

Mailing address

681 Cottage St NE
Salem, OR 97301-2419
Phone (336) 314-7105

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1548022601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 COTTAGE ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012419",
            "telephone_number": "336-314-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 COTTAGE ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012419",
            "telephone_number": "336-314-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERVISION HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "EBONY",
        "authorized_official_middle_name": "DECHELLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-314-7105"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.