COLUMBIACARE SERVICES (NPI# 1386720142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386720142 |
Entity Type | Organization |
Organization Name | COLUMBIACARE SERVICES |
Other Organization Name | WILLAMETTE ROSE |
Practice Address |
12505 Se Raymond St Portland OR 97236-3931 |
Mailing Address |
3587 Heathrow Way Medford OR 97504 |
Practice Telephone | 5037608300 |
Practice Fax Number | 5037608308 |
Mailing Telephone | 5418588170 |
Mailing Fax Number | 5418588167 |
Enumeration Date | 2006-10-27 |
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 | 801 | OR | Residential Treatment Facilities |
Y | 323P00000X | Psychiatric Residential Treatment Facility | 801 | OR | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 241906 | 05 | |
OR | W ROSE SERVICE PMT | 516052 | 01 |
Other Name | Type Code |
---|---|
Willamette Rose | 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 |
12505 SE RAYMOND ST |
City | PORTLAND |
State | OR |
Zip Code | 97236-3931 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922611441 | Rachel Elizabeth Garen | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2020-08-25 |
1104462761 | Julia A Demarre | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2019-11-19 |
1629612718 | Colton Hemenway | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2019-10-31 |
1649829888 | Dalia Isabel Solis-cortez | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2019-09-10 |
1740837087 | Mary Bredenkamp | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2019-08-21 |
1700344231 | Kaitlyn Nicole Trageser | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2019-03-04 |
1326512856 | Brianna Morales | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2019-01-17 |
1013404078 | Galen V Hartzell | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2018-04-16 |
1427556620 | Hannah M Jaimes-perez | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2018-01-23 |
1225548266 | Ryan B Thompson | Counselor | 12505 Se Raymond St, Portland, OR 97236-3931 | 2017-10-04 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
Find all providers in zip 97236 |
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 |
---|---|---|---|---|
1881851186 | Columbiacare Services | Psychiatric Residential Treatment Facility | 12501 Se Raymond St, Portland, OR 97236-3931 | 2008-05-22 |
1275620411 | Columbiacare Services | Psychiatric Residential Treatment Facility | 12511 Se Raymond St, Portland, OR 97236-3931 | 2006-10-09 |
1588132401 | Chase Steven Hardt | Psychiatric Residential Treatment Facility | 805 Se 151st Ave, Portland, OR 97233-2916 | 2018-11-08 |
1760939508 | Discovery Practice Management, Inc. | Psychiatric Residential Treatment Facility | 13221 Sw 68th Pkwy, Ste 440, Portland, OR 97223-8328 | 2016-09-09 |
1093186306 | Ginger's House | Psychiatric Residential Treatment Facility | 1000 Washington Ave, Portland, ME 04103-2751 | 2015-10-13 |
1588069801 | Columbiacare Services | Psychiatric Residential Treatment Facility | 17640 Ne Halsey St, Portland, OR 97230-6733 | 2014-10-29 |
1851592059 | Trillium Family Services, Inc. | Psychiatric Residential Treatment Facility | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2007-05-29 |
1215138425 | Trillium Family Services, Inc. | Psychiatric Residential Treatment Facility | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2007-05-29 |
1811198021 | Trillium Family Services | Psychiatric Residential Treatment Facility | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2007-05-29 |
1306987128 | Trillium Family Services | Psychiatric Residential Treatment Facility | 3550 Se Woodward St, Portland, OR 97202-1552 | 2007-02-12 |
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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.