COLUMBIACARE SERVICES (NPI# 1043410962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043410962 |
| Entity Type | Organization |
| Organization Name | COLUMBIACARE SERVICES |
| Other Organization Name | FAIRVIEW FIRS |
| Practice Address |
1945 Ne 205th Ave Fairview OR 97024-9622 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504 |
| Practice Telephone | 5036608050 |
| Practice Fax Number | 5034924651 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2009-05-13 |
| Authorized Official Name | MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5418588170 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 07863 | OR | Residential Treatment Facilities |
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 07863 | OR | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 274258 | 05 | |
| OR | PROVIDER NUMBER SERVICE | 517872 | 01 |
| Other Name | Type Code |
|---|---|
| Fairview Firs | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427553692 | Columbiacare Services | Clinic/Center | 29415 Russell St, Gold Beach, OR 97444 | 2018-03-28 |
| 1255835104 | Columbiacare Services | Clinic/Center | 850 Swing Ln, Medford, OR 97501-1790 | 2018-03-23 |
| 1982140588 | Columbiacare Services | Clinic/Center | 17720 Ne Halsey St # 1, Portland, OR 97230-6734 | 2017-01-06 |
| 1831640192 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 8336 Highway 62, White City, OR 97530 | 2016-10-20 |
| 1871946640 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 29841 Hillcrest St, Gold Beach, OR 97444-8714 | 2016-07-18 |
| 1194173898 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 410 Maple St, Brookings, OR 97415 | 2016-06-03 |
| 1679941785 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 130 Se 119th Ave, Portland, OR 97216-3704 | 2015-09-04 |
| 1346637816 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17710 Halsey Crc, Portland, OR 97230 | 2015-04-22 |
| 1700273638 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17700 Ne Halsey St, Portland, OR 97230-6734 | 2015-04-17 |
| 1740679182 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 11380 Se Greenburg Rd #9, Tigard, OR 97223 | 2015-01-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | COLUMBIACARE SERVICES, INC | 3587 Heathrow Way, Medford, OR 97504 |
| Oregon Corporations, Companies and Business Names | COLUMBIACARE SERVICES, INC. | 3587 Heathrow Way, Medford, OR 97504 |
| Street Address |
1945 NE 205TH AVE |
| City | FAIRVIEW |
| State | OR |
| Zip Code | 97024-9622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760095277 | Michaela Lynette Rushing | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2020-08-25 |
| 1831678556 | Raquel L Graham | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2018-08-13 |
| 1225553027 | Clinton Stiffler | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2017-08-14 |
| 1508319476 | Susan Mihm | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2016-07-27 |
| 1598119174 | Angela Van Ecken | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2016-04-20 |
| 1144688920 | Sarah Bourgeois | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2016-02-08 |
| 1053779835 | Lisa Cordero | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2016-02-08 |
| 1962860742 | Antionette Golden | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2016-02-08 |
| 1871951657 | Sharel Highland | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2016-02-08 |
| 1780042564 | Edna Leed | Counselor | 1945 Ne 205th Ave, Fairview, OR 97024-9622 | 2016-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255792560 | Brent Labhart | Counselor | 17720 Ne Halsey, Fairview, OR 97024 | 2016-03-14 |
| 1720325954 | Glen R Edgerton | Internal Medicine | 3797 Ne Fairview Lake Way, Fairview, OR 97024 | 2013-01-08 |
| 1073657003 | Aoife O'sullivan | Family Medicine | Hyster-yale, 4000 Ne Blue Lake Road, Fairview, OR 97024 | 2007-02-15 |
| 1780240713 | Christie Ellen Thompson | Massage Therapist | 1659 Ne Market Drive, Fairview, OR 97024 | 2019-05-15 |
| 1003325531 | Daniel L Hubbell | Chiropractor | 1659 Ne Market Dr, Fairview, OR 97024 | 2017-09-27 |
| 1528338423 | Denise Irene Houck | Nurse Practitioner | 1800 Ne Market Drive, Fairview, OR 97024 | 2012-01-09 |
| 1467625632 | Lisa Camille Gibson | Registered Nurse | 722 Ne 162nd Ave, Albertina Kerr Center Youth & Family Services, Portland, OR 97024 | 2008-04-09 |
| 1447624663 | Western Psychological and Counseling Services PC | Health Maintenance Organization | 22070 Ne Chinook Way, Fairview, OR 97024-2647 | 2015-11-26 |
| 1891815957 | Robert Craig Stassi I | Chiropractor | 1606 Ne 223rd Ave, Fairview, OR 97024-2662 | 2007-03-30 |
| 1811168925 | Laurie Anne Mcadam | Occupational Therapy Assistant | 100 Bridge St, Fairview, OR 97024-2666 | 2008-03-17 |
| Find all providers in zip 97024 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932714581 | Elderly and Disabled Services | Psychiatric Residential Treatment Facility | 248 Mace Rd, Medford, OR 97501-1280 | 2020-09-10 |
| 1144761784 | Lifeways, Inc | Psychiatric Residential Treatment Facility | 1212 W Linda Ave, Hermiston, OR 97838-6946 | 2017-03-15 |
| 1679959761 | Candice Ann Hopper | Psychiatric Residential Treatment Facility | 16326 Butteville Rd Ne, Woodburn, OR 97071-8408 | 2015-07-31 |
| 1568883254 | Columbiacare Services | Psychiatric Residential Treatment Facility | 2575 Westgate Bldg F, Pendleton, OR 97801-9613 | 2013-12-23 |
| 1477974293 | Columbiacare Services | Psychiatric Residential Treatment Facility | 2575 Westgate Bldg E, Pendleton, OR 97801-9613 | 2013-12-20 |
| 1235440702 | Trillium Family Services | Psychiatric Residential Treatment Facility | 3009 Nw Grant Pl, Corvallis, OR 97330-1814 | 2010-06-29 |
| 1346494101 | Trillium Family Services | Psychiatric Residential Treatment Facility | 229 Se 4th Ave, Albany, OR 97321 | 2008-11-06 |
| 1881851186 | Columbiacare Services | Psychiatric Residential Treatment Facility | 12501 Se Raymond St, Portland, OR 97236-3931 | 2008-05-22 |
| 1831395375 | Trillium Family Services | Psychiatric Residential Treatment Facility | 2430 Nw Rolling Green Dr, #17, Corvallis, OR 97330-3778 | 2007-06-22 |
| 1962607549 | Children's Farm Home | Psychiatric Residential Treatment Facility | 954 Nw Sycamore Ave, Apt 8, Corvallis, OR 97330-7107 | 2007-06-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.