Southern Oregon Behavioral Wellness Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SOUTHERN OREGON BEHAVIORAL WELLNESS CENTER

Practice address

1148 Stanford Ave
Medford, OR 97504-8924

Phone

(541) 591-7838

NPI assigned

Aug 19, 2020

Organization subpart

No

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

Authorized official

Name

Lauren J Oxholm

Title

Manager

Phone

(541) 709-5056

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1801408901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048284",
            "telephone_number": "541-790-5056",
            "fax_number": "833-639-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 STANFORD AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048924",
            "telephone_number": "541-591-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OREGON BEHAVIORAL WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2021-05-19",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "OXHOLM",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "541-709-5056"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sobehavioralwellnesscenter.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1609 E Barnett Rd",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975048284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Soundview Medical Supply, LLC
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• Tyler Southard, PA-C
• Southern Oregon Anesthesia Partners LLC
• Southern Oregon Audiology, Inc.
• Southern Oregon Cardiology LLC
• Southern Oregon Childrens Clinic
• Southern Oregon Chiropractic, LLC
• Southern Oregon Denture & Dental
• Southern Oregon Direct Primary Care LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Medford, OR
• Providers in Medford, OR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.