Whalio Doctors

NPI 1043410962

Columbiacare Services

Organisation Psychiatric Residential Treatment Facility Fairview, OR

Practice location

Address
1945 NE 205th Ave, Fairview, OR 97024-9622
Phone
(503) 660-8050
Fax
(503) 492-4651
Mailing address
3587 Heathrow Way, Medford, OR 97504

Authorised official

Name
Robert C Beckett
Title
Executive Director
Phone
(541) 858-8170

Registered specialties (2)

Psychiatric Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 323P00000X Licence 07863 (OR)
Mental Illness Community Based Residential Treatment Facility
Residential Treatment Facilities Taxonomy 320800000X Licence 07863 (OR)

Registry record

NPI
1043410962
Entity type
Organization
NPI issued
19 Jul 2007
Record last updated
13 May 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.