JASPER MOUNTAIN (NPI# 1497821680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497821680 |
Entity Type | Organization |
Organization Name | JASPER MOUNTAIN |
Practice Address |
37875 Jasper Lowell Rd Jasper OR 97438-9751 |
Practice Telephone | 5417471235 |
Practice Fax Number | 5417474722 |
Mailing Telephone | 5417471235 |
Mailing Fax Number | 5417474722 |
Enumeration Date | 2006-11-28 |
Last Update Date | 2009-09-07 |
Authorized Official Name | MR. DONALD LANDAUER (CFO) |
Authorized Official Telephone | 5417471235 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | OR | Residential Treatment Facilities | |
N | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
OR | Respite Care Facility | |
Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | OR | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 313495 | 05 | |
OR | 178087 | 05 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | JASPER MOUNTAIN | 37875 Jasper Lowell Rd, Jasper, OR 97438 |
Washington State Corporations | JASPER MOUNTAIN ENTERPRISES, LLC | 100 Ward Rd, Dayton, WA 99328-9694 |
Washington State Corporations | JASPER MOUNTAIN VENTURES, LLC | 610 N Front St, Dayton, WA 99328-1033 |
Street Address |
37875 JASPER LOWELL RD |
City | JASPER |
State | OR |
Zip Code | 97438-9751 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013518117 | Taylor Lyn Sorensen | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-11-04 |
1871107425 | Cody L Lee | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-09-01 |
1639782535 | Madison H Correia | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-08-28 |
1558974832 | Laurel Louise King | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-08-26 |
1477165348 | Larkin Marie Lowry | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-08-20 |
1093325789 | Brittany Szalkiewicz | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-08-06 |
1578171930 | Jaida Lilian Hardinger | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-07-21 |
1700408135 | Sara Katelyn Walz | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-05-07 |
1245861590 | Rachael Ridel Bennett | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-01-27 |
1487293148 | Kayleigh Diane Truitt | Social Worker | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2019-12-29 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225151707 | Hyla M Dobaj | Counselor | 37875 Jasper Lowell Rd., Jasper, OR 97438 | 2007-04-09 |
1134370406 | Benjamin Daniel Lane George | Counselor | 37446 Jasper Lowell Rd, Jasper, OR 97438-9719 | 2008-10-06 |
1528219862 | Julie R. Simmonds | Counselor | 39477 Little Fall Creek Rd, Fall Creek, OR 97438-9726 | 2008-10-06 |
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 |
---|---|---|---|---|
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 |
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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.