NPIMap

Organization Active NPI

Klamath Tribal Health & Family Services

  • Children's Substance Abuse Rehabilitation Facility
  • Klamath Falls, OR
National Provider Identifier
1578864641
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
Legal business name
KLAMATH TRIBAL HEALTH & FAMILY SERVICES
Practice address
121 Iowa St.
Klamath Falls, OR 97601
Phone
(541) 882-1487
Fax
(541) 882-1670
NPI assigned
Nov 5, 2010
Organization subpart
Yes
Parent organization
KLAMATH TRIBAL HEALTH & FAMILY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Authorized official

Name
Leroy Jackson Jr.
Title
Health General Manager
Phone
(541) 882-1487

Specialties & licenses 1

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

Addresses

Primary practice location

121 Iowa St.
Klamath Falls, OR 97601

Mailing address

3949 South 6TH St.
Klamath Falls, OR 97603-4746
Phone (541) 882-1487

Other names 1

  • Klamath Youth Regional Treatment Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Klamath Tribal HLTH Family6 organizations share this tax ID, including this one
Part of
Klamath Tribal HLTH Family

Other organizations with this tax ID 5

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

Locations

121 Iowa St
Klamath Falls, OR 97601
Phone (541) 882-1487

Practitioners & affiliated clinicians

Practitioners 1

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": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1578864641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 SOUTH 6TH ST.",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034746",
            "telephone_number": "541-882-1487",
            "fax_number": "541-882-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 IOWA ST.",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97601",
            "telephone_number": "541-882-1487",
            "fax_number": "541-882-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLAMATH TRIBAL HEALTH & FAMILY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KLAMATH TRIBAL HEALTH & FAMILY SERVICES",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LEROY",
        "authorized_official_title_or_position": "HEALTH GENERAL MANAGER",
        "authorized_official_telephone_number": "541-882-1487",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klamath Youth Regional Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.