NPIMap

Organization Active NPI

Wallowa Valley Center for Wellness

  • Clinic/Center
  • Enterprise, OR
National Provider Identifier
1558817528
Registry record updated Nov 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WALLOWA VALLEY CENTER FOR WELLNESS
Practice address
606 Medical Pkwy
Enterprise, OR 97828-5140
Phone
(541) 426-4524
NPI assigned
Aug 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2024

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

Authorized official

Name
Robin Hopkins
Title
Human Resources
Phone
(541) 426-4524

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Clinic/Center 261Q00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

606 Medical Pkwy
Enterprise, OR 97828-5140

Mailing address

PO Box 268
Enterprise, OR 97828-0268
Phone (541) 426-4524

Other identifiers 2

IdentifierTypeStateIssuer
210511MedicaidOR
213546MedicaidOR

National Provider Directory

National Provider Directory
Tax ID family
Wallowa Valley Center for Wellness5 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.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730592000000",
    "number": "1558817528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978280268",
            "telephone_number": "541-426-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 MEDICAL PKWY",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978285140",
            "telephone_number": "541-426-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLOWA VALLEY CENTER FOR WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A",
        "authorized_official_last_name": "HOPKINS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "HUMAN RESOURCES",
        "authorized_official_telephone_number": "541-426-4524"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210511",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213546",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.