NPIMap

Organization Active NPI

Columbiacare Services

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
National Provider Identifier
1679941785
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
COLUMBIACARE SERVICES
Practice address
130 SE 119TH Ave
Portland, OR 97216-3704
Phone
(541) 858-8170
Fax
(541) 858-8167
NPI assigned
Sep 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Authorized official

Name
Mike David Sewitsky
Title
Finance Manager
Phone
(541) 858-8170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

130 SE 119TH Ave
Portland, OR 97216-3704

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 858-8170

National Provider Directory

National Provider Directory
Tax ID family
Columbiacare Services Inc42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1679941785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HEATHROW WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044004",
            "telephone_number": "541-858-8170",
            "fax_number": "541-858-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SE 119TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163704",
            "telephone_number": "541-858-8170",
            "fax_number": "541-858-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIACARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "SEWITSKY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "FINANCE MANAGER",
        "authorized_official_telephone_number": "541-858-8170"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.