NPIMap

Organization Active NPI

Adolescent Day Treatment Center Inc of Douglas County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Winston, OR
National Provider Identifier
1629168166
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
CERTIFCATE OF APPROV Issued in OR
Legal business name
ADOLESCENT DAY TREATMENT CENTER INC OF DOUGLAS COUNTY
Practice address
671 S.W. Main
Winston, OR 97496
Phone
(541) 679-6129
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Ms. Bonna M Meyer
Title
Interim Director
Phone
(541) 679-6129

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CERTIFCATE OF APPROV OR Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X CERTIFICATE APPROVAL OR

Addresses

Primary practice location

671 S.W. Main
Winston, OR 97496

Mailing address

PO Box 2259
Winston, OR 97496-2259
Phone (541) 679-6129

Other identifiers 2

IdentifierTypeStateIssuer
297927MedicaidOR
297928MedicaidOR

Other names 1

  • Riverside Center Doing business as

National Provider Directory

National Provider Directory

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1629168166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2259",
            "city": "WINSTON",
            "state": "OR",
            "postal_code": "974962259",
            "telephone_number": "541-679-6129",
            "fax_number": "541-679-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 S.W. MAIN",
            "city": "WINSTON",
            "state": "OR",
            "postal_code": "97496",
            "telephone_number": "541-679-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADOLESCENT DAY TREATMENT CENTER INC OF DOUGLAS COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "BONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INTERIM DIRECTOR",
        "authorized_official_telephone_number": "541-679-6129",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OR",
            "license": "CERTIFCATE OF APPROV",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "OR",
            "license": "CERTIFICATE APPROVAL",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297927",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297928",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.