NPIMap

Organization Active NPI

Dept. of Human Srvcs/Office of Fin. Srvcs Dba: Irs/Eopc/Eotc/Osh/Osh-P

Doing business as Eastern Oregon Training Center

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Pendleton, OR
National Provider Identifier
1720023807
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
6021 Issued in OR
Legal business name
DEPT. OF HUMAN SRVCS/OFFICE OF FIN. SRVCS DBA: IRS/EOPC/EOTC/OSH/OSH-P
Doing business as
Eastern Oregon Training Center
Practice address
2525 Westgate
Pendleton, OR 97801-9613
Phone
(541) 276-0820
Fax
(541) 276-1147
NPI assigned
Jun 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Authorized official

Name
Russell R. Kittrell
Title
Institutional Revenue Section MGR.
Phone
(503) 945-9440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 6021 OR Primary

Addresses

Primary practice location

2525 Westgate
Pendleton, OR 97801-9613

Mailing address

PO Box 14900
Salem, OR 97309-5016
Phone (503) 945-9469

Other identifiers 1

IdentifierTypeStateIssuer
400093MedicaidOR

Other names 1

  • Eastern Oregon Training Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eastern Oregon Psychiat6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

2525 Westgate
Pendleton, OR 97801
Phone (541) 429-8721

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1720023807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14900",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973095016",
            "telephone_number": "503-945-9469",
            "fax_number": "503-947-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 WESTGATE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978019613",
            "telephone_number": "541-276-0820",
            "fax_number": "541-276-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPT. OF HUMAN SRVCS/OFFICE OF FIN. SRVCS DBA: IRS/EOPC/EOTC/OSH/OSH-P",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "KITTRELL",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "INSTITUTIONAL REVENUE SECTION MGR.",
        "authorized_official_telephone_number": "503-945-9440"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OR",
            "license": "6021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400093",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Oregon Training Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.