COLUMBIACARE SERVICES


Address: 3587 Heathrow Way, Medford, OR 97504-4004
Phone: 5418588170

COLUMBIACARE SERVICES (NPI# 1508126368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508126368
Entity Type Organization
Organization Name COLUMBIACARE SERVICES
Other Organization Name JENNINGS LODGE
Practice Address 3587 Heathrow Way
Medford
OR 97504-4004
Mailing Address 4545 Se Ina Ave
Milwaukie
OR 97267-5916
Practice Telephone 5418588170
Mailing Telephone 5418588170
Enumeration Date 2012-05-25
Last Update Date 2012-05-25
Authorized Official Name MR. ROBERT BECKETT (EXECUTIVE DIRECTOR)
Authorized Official Telephone 5418588170
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Jennings Lodge Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 3587 HEATHROW WAY
City MEDFORD
State OR
Zip Code 97504-4004

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104962471 Gaelen Laurel Thurow Counselor 3587 Heathrow Way, Medford, OR 97504-4004 2007-01-30
1841837796 Anastasia Olga Zukowski Counselor 3587 Heathrow Way, Medford, OR 97504-4004 2019-12-10
1497227995 Gary J Mcconahay Counselor 3587 Heathrow Way, Medford, OR 97504-4004 2018-12-20
1689144750 Kirby Douglas Rider Case Management 3587 Heathrow Way, Medford, OR 97504-4004 2018-11-30
1174002091 Tiffany A Weldon Registered Nurse 3587 Heathrow Way, Medford, OR 97504-4004 2018-08-10
1265965354 Joseph Chick Counselor 3587 Heathrow Way, Medford, OR 97504-4004 2017-04-06
1992245625 Columbiacare Services Clinic/Center 3587 Heathrow Way, Suite #1, Medford, OR 97504-4004 2017-02-28
1750826616 Columbiacare Services Case Management 3587 Heathrow Way, Medford, OR 97504-4004 2017-01-03
1972047660 Zola Hulet Case Manager/Care Coordinator 3587 Heathrow Way, Medford, OR 97504-4004 2016-12-14
1710421540 Stephanie Lynn Lane Case Manager/Care Coordinator 3587 Heathrow Way, Medford, OR 97504-4004 2016-12-13
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225673833 Lydia D Sneed Behavioral Analyst 3707 Citation Way, Suite 102, Medford, OR 97504 2019-11-07
1114577368 Heather Ashley Fronek Nurse Practitioner 2825 E. Barnett Rd., Medford, OR 97504 2019-09-18
1255809109 Justin Blasdel Technician, Health Information 3250 Lone Pine Rd, Medford, OR 97504 2018-11-08
1396220133 Aimee K Michel Massage Therapist 3550 National Dr., Medford, OR 97504 2018-09-27
1437646908 Zola Dental Medford LLC Dentist 922 E Main, Medford, OR 97504 2018-04-19
1376068015 Megan Leggett Counselor 777 Murphy Road, Medford, OR 97504 2017-08-03
1023547536 Joshua Morgan Rice Dentist 1117 E Main St Ste 1, Medford, OR 97504 2017-06-08
1427580232 Paul James Dean Counselor 1175 Main St Ste 1c, Medford, OR 97504 2017-03-30
1811443542 Taya Adams Doula 1201 Progress Dr #90, Medford, OR 97504 2016-09-01
1174076228 Avalon Health Care - Hearthstone, LLC Skilled Nursing Facility 2091 E. Barnett Road, Medford, OR 97504 2016-07-25
Find all providers in zip 97504

Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508218553 Columbiacare Serices Community Based Residential Treatment Facility, Mental Illness 1998 Sky Park Dr Ste 102, Medford, OR 97504-5395 2016-07-01
1003262106 Catholic Charities Diocese of Trenton Community Based Residential Treatment Facility, Mental Illness 417 Tabernacle Rd, Medford, NJ 08055-2019 2016-05-06
1750780227 Westbridge Inc Community Based Residential Treatment Facility, Mental Illness 275 Mystic Ave, Ste C, Medford, MA 02155-6301 2014-08-20
1780966606 Walgreens Community Based Residential Treatment Facility, Mental Illness 113 Monument St, Medford, MA 02155-3538 2011-09-16
1134270341 Laurel Hill Inn, Ltd Community Based Residential Treatment Facility, Mental Illness 121 Mystic St, Medford, MA 02155-3463 2007-01-15
1861918278 Columbiacare Services Inc Community Based Residential Treatment Facility, Mental Illness 2016 Terrel Dr, Medford, OR 97501-8154 2017-08-17
1548511694 Options for Southern Oregon Community Based Residential Treatment Facility, Mental Illness 1911 Hazel Ave, Medford, OR 97501-1630 2012-09-28
1104186014 Columbiacare Services Community Based Residential Treatment Facility, Mental Illness 3587 Heathrow Way, Medford, OR 97504-4004 2012-05-24
1780988253 Jackson County Mental Health Community Based Residential Treatment Facility, Mental Illness 1911 Hazel Ave, Medford, OR 97501-1630 2010-12-27
1649466475 Columbiacare Services Inc Community Based Residential Treatment Facility, Mental Illness 3587 Heathrow Way, Medford, OR 97504 2007-09-14
Find all providers in MEDFORD

Competitor

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City MEDFORD
Zip Code 97504

Improve Information

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Dataset Information

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.

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