Sriponya Collective

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SRIPONYA COLLECTIVE

Practice address

1080 SE Bluegrass LN
Madras, OR 97741-1642

Phone

(541) 408-0968

NPI assigned

Mar 21, 2024

Last updated

Mar 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Joyce Eales, CHW, PSS, JD

Title

Executive Director

Phone

(541) 408-0968

Specialties & licenses 1

Addresses

Other names 1

• Parousia Former legal business name

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1699535096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977410052",
            "telephone_number": "541-408-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 SE BLUEGRASS LN",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411642",
            "telephone_number": "541-408-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRIPONYA COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "EALES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JOYCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-408-0968",
        "authorized_official_credential": "CHW, PSS, JD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parousia",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Joella Smith, CRM
• Katherine Snyder, MD
• Laura Ashly Sparrell, CADC-1
• Susan Speck, LPC
• Lawrence Squiemphen, CADC I
• St. Charles Health System, Inc.
• St. Charles Health System, Inc. (St. Charles - Madras)
• St. Charles Health System, Inc. (St. Charles Madras - Hospice)
• St. Charles Health System, Inc. (St. Charles Home Health)
• St. Charles Health System, Inc. (St. Charles - Madras)

• Community/Behavioral Health Agency in Madras, OR
• Providers in Madras, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.