MARION COUNTY HEALTH DEPARTMENT (NPI# 1356628119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356628119 |
| Entity Type | Organization |
| Organization Name | MARION COUNTY HEALTH DEPARTMENT |
| Other Organization Name | ADULT ALCOHOL AND DRUG TREATMENT |
| Practice Address |
2035 Davcor St Se Salem OR 97302-1595 |
| Mailing Address |
Po Box 17668 Salem OR 97305-7668 |
| Practice Telephone | 5033621399 |
| Practice Fax Number | 5033624409 |
| Mailing Telephone | 5033621399 |
| Mailing Fax Number | 5033624409 |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2011-11-08 |
| Authorized Official Name | LAURA KRISTIE MORENO (CASE MANAGEMENT) |
| Authorized Official Telephone | 5033621399 |
| Authorized Official Credential | CADCI |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 190702 | OR | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Adult Alcohol and drug Treatment | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740543297 | Marion County Health Department | Substance Abuse Rehabilitation Facility | 3529 Fisher Rd Ne, Salem, OR 97305 | 2012-06-20 |
| 1811271778 | Marion County Health Department | Public Health or Welfare | 1801 Se 32ndave, Ocala, FL 34471 | 2011-10-10 |
| 1700056694 | Marion County Health Department | Clinic/Center | 747 Horseback Ct Ne, Salem, OR 97301-3195 | 2008-03-06 |
| 1689634685 | Marion County Health Department | Public Health or Welfare | 111a Baker Street, Buena Vista, GA 31803-0404 | 2006-03-24 |
| 1891048864 | Marion County Health Department | Registered Nurse | 1801 Se 32nd Ave, Ocala, FL 34478-5532 | 2012-10-16 |
| 1184976482 | Marion County Health Department | Registered Nurse | 1801 Se 32nd Ave, Ocala, FL 34471-5532 | 2012-10-10 |
| 1487881959 | Marion County Health Department | Community Based Residential Treatment Facility, Mental Illness | 2435 Greenway Dr Ne, Salem, OR 97301-4535 | 2009-06-11 |
| 1073758199 | Marion County Health Department | Case Management | 3180 Center St Ne, Salem, OR 97301-4532 | 2008-12-03 |
| 1528219326 | Marion County Health Department | Public Health or Welfare | 3180 Center St Ne, Suite 2360, Salem, OR 97301-4532 | 2008-10-10 |
| 1952578668 | Marion County Health Department | Public Health or Welfare | 118 Cross Creek Blvd, Salem, IL 62881-1920 | 2008-05-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MARION COUNTY HEALTH DEPARTMENT | 3180 Center St Ne Ste 200, Salem, OR 97301-4532 |
| Street Address |
2035 DAVCOR ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302-1595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619031077 | Vicki Jean Tournay | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2006-12-20 |
| 1295234748 | Richard Narvaez | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2018-02-09 |
| 1215443700 | Pamela Jones | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2017-12-19 |
| 1366961245 | David Arley Mintken | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2017-09-12 |
| 1902324486 | Krystal Gail Roloff | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2017-09-05 |
| 1811436587 | Ashley Marie Anastasio | Licensed Practical Nurse | 2035 Davcor St Se, Salem, OR 97302-1595 | 2017-02-15 |
| 1811447808 | Alexandria Mary Kolody | Licensed Practical Nurse | 2035 Davcor St Se, Salem, OR 97302-1595 | 2016-10-13 |
| 1720456171 | Charles Edward Johnson | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2015-09-02 |
| 1457747578 | Mary Courser | Registered Nurse | 2035 Davcor St Se, Salem, OR 97302-1595 | 2015-04-15 |
| 1073917316 | Anthony Sparzo | Counselor | 2035 Davcor St Se, Salem, OR 97302 | 2014-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578078234 | Arden Wellness LLC | Substance Abuse Rehabilitation Facility | 15 Ermer Rd Unit 201, Salem, NH 03079-1273 | 2017-12-04 |
| 1710418447 | Phc of Virginia, LLC | Substance Abuse Rehabilitation Facility | 120 Roanoke Blvd, Salem, VA 24153-4908 | 2017-03-24 |
| 1982017992 | Odyssey Complete LLC | Substance Abuse Rehabilitation Facility | 465 Commercial St Ne Ste 150, Salem, OR 97301-3414 | 2014-06-06 |
| 1639228778 | Phc of Virginia, Inc. | Substance Abuse Rehabilitation Facility | 405 Kimball Avenue, Salem, VA 24153 | 2007-01-09 |
| 1730635608 | Bridgeway Recovery Services | Substance Abuse Rehabilitation Facility | 3321 Harold Dr Ne, Salem, OR 97305-1339 | 2016-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669000865 | Mid-valley Healthcare, Inc. | Substance Abuse Rehabilitation Facility | 111 N Main St Ste B, Lebanon, OR 97355-2869 | 2020-04-01 |
| 1548822216 | Oregon Recovery Behavioral Health | Substance Abuse Rehabilitation Facility | 1184 Mcgee Ct Ne Ste 200, Keizer, OR 97303-9443 | 2019-07-02 |
| 1972011682 | Women's Enrichment Counseling | Substance Abuse Rehabilitation Facility | 1300 John Adams St Ste 103, Oregon City, OR 97045-1691 | 2018-01-16 |
| 1356851042 | Debra Monaghan | Substance Abuse Rehabilitation Facility | 1271 Sw 9th St, Warrenton, OR 97146-9418 | 2017-10-06 |
| 1619429396 | Serenity Lane | Substance Abuse Rehabilitation Facility | 304 Dartmoor Drive, Eugene, OR 97401 | 2016-10-28 |
| 1043760838 | Pacific Crest Trail Detox LLC | Substance Abuse Rehabilitation Facility | 7708 Se Clackamas Rd, Milwaukie, OR 97267-4405 | 2016-10-05 |
| 1477002228 | Treehouse Nw Inc | Substance Abuse Rehabilitation Facility | 4713 N Albina Ave, Suite 301, Portland, OR 97217-2605 | 2016-09-21 |
| 1154785475 | Blvd Centers, Inc | Substance Abuse Rehabilitation Facility | 1316 Se 12th Ave, Portland, OR 97214-3604 | 2016-04-12 |
| 1851757454 | Circle of Trust Healing Center, LLC | Substance Abuse Rehabilitation Facility | 3300 Butler Creek Rd, Ashland, OR 97520-9173 | 2016-01-12 |
| 1700258258 | La Pine Ktc, LLC | Substance Abuse Rehabilitation Facility | 16161 Burgess Rd, La Pine, OR 97739-9533 | 2015-10-23 |
| Find all providers with the same taxonomy | ||||
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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.