NPIMap

Organization Active NPI

Klamath Youth Development Center

  • Community/Behavioral Health Agency
  • Klamath Falls, OR
National Provider Identifier
1578991709
Registry record updated Oct 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KLAMATH YOUTH DEVELOPMENT CENTER
Practice address
2210 N Eldorado Ave
Klamath Falls, OR 97601
Phone
(541) 883-1030
NPI assigned
Oct 25, 2013
Last updated
Oct 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2013

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

Authorized official

Name
Ashley Hanna Waldron, M.S
Title
Treatment Specialist
Phone
(541) 883-1030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2210 N Eldorado Ave
Klamath Falls, OR 97601

Mailing address

1527 Lookout Ave
Klamath Falls, OR 97601
Phone (541) 892-2221

Other identifiers 1

IdentifierTypeStateIssuer
223354MedicaidOR

National Provider Directory

National Provider Directory
Tax ID family
Klamath Child and Family Treatment Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1382659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1578991709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 LOOKOUT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97601",
            "telephone_number": "541-892-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 N ELDORADO AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97601",
            "telephone_number": "541-883-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLAMATH YOUTH DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-25",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "HANNA",
        "authorized_official_title_or_position": "TREATMENT SPECIALIST",
        "authorized_official_telephone_number": "541-883-1030",
        "authorized_official_credential": "M.S"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223354",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 25, 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.