KAIROS NORTHWEST (NPI# 1366865495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366865495 |
| Entity Type | Organization |
| Organization Name | KAIROS NORTHWEST |
| Practice Address |
210 Tacoma St Grants Pass OR 97526-9370 |
| Mailing Address |
715 Sw Ramsey Ave Grants Pass OR 97527-5500 |
| Practice Telephone | 5414673302 |
| Mailing Telephone | 5419564943 |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2014-01-24 |
| Authorized Official Name | MRS. SUSAN BOLDT (OPERATIONS DIRECTOR) |
| Authorized Official Telephone | 5414745579 |
| Authorized Official Credential | M.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487782900 | Kairos Northwest | Community Based Residential Treatment Facility, Mental Illness | 715 Ramsey Ave, Grants Pass, OR 97527-5500 | 2007-02-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | KAIROS NORTHWEST | 1750 Nebraska Ave Bldg A, Grants Pass, OR 97527 |
| Street Address |
210 TACOMA ST |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526-9370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447523956 | Dorothy Louise Torelli | Social Worker | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2012-02-14 |
| 1063805661 | Brandy Stromme | Counselor | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2015-03-06 |
| 1255749206 | Kathleen Ann Tatom | Counselor | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2014-07-22 |
| 1346651254 | Heather Nease | Counselor | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2014-05-13 |
| 1982024527 | Christopher Wright | Counselor | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2014-04-22 |
| 1881011427 | Andromida Rosado | Counselor | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2014-03-20 |
| 1891118923 | Joel Shippy | Counselor | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2014-01-24 |
| 1245651793 | Anna Boak | Counselor | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2014-01-01 |
| 1144651415 | Kairos | Counselor | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2013-12-11 |
| 1932538949 | Hypatia Couick | Counselor | 210 Tacoma St, Grants Pass, OR 97526-9370 | 2013-11-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1700364502 | Premier Community Supports, LLC. | Day Training, Developmentally Disabled Services | 1439 Ne 6th St Ste C, Grants Pass, OR 97526 | 2018-08-02 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| Find all providers in zip 97526 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033597042 | Options for Southern Oregon | Community Based Residential Treatment Facility, Mental Illness | 310 Bushnell Way, Grants Pass, OR 97527-9103 | 2015-05-11 |
| 1093085573 | Alma Delia Robles | Community Based Residential Treatment Facility, Mental Illness | 711 Ramsey Ave, Grants Pass, OR 97527 | 2011-12-30 |
| 1023253770 | Options for Southern Oregon | Community Based Residential Treatment Facility, Mental Illness | 324 Sw Ramsey Ave, Grants Pass, OR 97527-5529 | 2008-12-10 |
| 1346485042 | Options for Southern Oregon | Community Based Residential Treatment Facility, Mental Illness | 900 Hitching Post Rd, Grants Pass, OR 97526-9710 | 2008-12-09 |
| 1487782900 | Kairos Northwest | Community Based Residential Treatment Facility, Mental Illness | 715 Ramsey Ave, Grants Pass, OR 97527-5500 | 2007-02-28 |
| 1083859979 | Options for Southern Oregon | Community Based Residential Treatment Facility, Mental Illness | 1644 Carnahan Dr, Grants Pass, OR 97527-4724 | 2008-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932059 | Rainrock Treatment Center, LLC | Community Based Residential Treatment Facility, Mental Illness | 2990 Brandywine Dr, West Linn, OR 97068-8313 | 2020-11-06 |
| 1770101545 | Northwest Premier LLC | Community Based Residential Treatment Facility, Mental Illness | 560 W Rose St, Lebanon, OR 97355-2624 | 2020-07-08 |
| 1538793856 | Tamekio Russell | Community Based Residential Treatment Facility, Mental Illness | 2072 Sw Sandlewood Pl, Gresham, OR 97080-9752 | 2020-02-25 |
| 1487290342 | Andrew J Thomas | Community Based Residential Treatment Facility, Mental Illness | 2568 Sw 1st Ave, Ontario, OR 97914-1877 | 2019-11-25 |
| 1760046528 | The Sachiko Group, Inc | Community Based Residential Treatment Facility, Mental Illness | 3517 Sw Wonderview Ave, Gresham, OR 97080-8574 | 2019-04-26 |
| 1831660984 | Olthyme LLC | Community Based Residential Treatment Facility, Mental Illness | 30803 Jeppeson Ln, Hermiston, OR 97838-6222 | 2018-12-16 |
| 1679073712 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 622 57th St, Springfield, OR 97478-6821 | 2018-02-15 |
| 1356858369 | Scott Richardson | Community Based Residential Treatment Facility, Mental Illness | 3934 Rio Vista Way, Klamath Falls, OR 97603 | 2017-12-29 |
| 1558877407 | Best Care Treatment Services | Community Based Residential Treatment Facility, Mental Illness | 1470 Nw 4th St, Redmond, OR 97756-1366 | 2017-12-14 |
| 1831640192 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 8336 Highway 62, White City, OR 97530 | 2016-10-20 |
| Find all providers with the same taxonomy | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
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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.