MY LIFE ALIVE LLC (NPI# 1699129445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699129445 |
| Entity Type | Organization |
| Organization Name | MY LIFE ALIVE LLC |
| Practice Address |
388 State St Suite 705 Salem OR 97301-3866 |
| Mailing Address |
Po Box 4461 Salem OR 97302-8461 |
| Practice Telephone | 5038073444 |
| Mailing Telephone | 5038073444 |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |
| Authorized Official Name | CARMEN HEIDECKE (COUNSELOR) |
| Authorized Official Telephone | 5038073444 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | C4060 | OR | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MY LIFE ALIVE LLC | 1824 Church Street Ne, Salem, OR 97301 |
| Street Address |
388 STATE ST SUITE 705 |
| City | SALEM |
| State | OR |
| Zip Code | 97301-3866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588728430 | John W Reed | Social Worker | 388 State St, Suite 455, Salem, OR 97301-3532 | 2006-12-21 |
| 1659758167 | Adagio Therapy Center, LLC | Social Worker | 388 State St, Suite 707, Salem, OR 97301-3866 | 2015-05-05 |
| 1023261526 | Morgan Looney | Counselor | 388 State St, Salem, OR 97301-3866 | 2008-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881153948 | Pause Counseling, LLC | Community/Behavioral Health | 202 Main St Ste 102104, Salem, NH 03079-3170 | 2019-03-18 |
| 1821564436 | Bokker Enterprises, Inc. | Community/Behavioral Health | 115 Turner Lane, Ste #2, Salem, AR 72576 | 2018-10-22 |
| 1477050326 | Oregon Wellness Network | Community/Behavioral Health | 2615 Portland Rd Ne, Salem, OR 97301-0124 | 2018-04-08 |
| 1700335536 | Joel M Suckow-md, LLC | Community/Behavioral Health | 388 State St Ste 701, Salem, OR 97301 | 2016-09-21 |
| 1073979696 | Family Preservation Services, Inc | Community/Behavioral Health | 4507 Malus Dr, Salem, VA 24153-7921 | 2016-01-12 |
| 1700252954 | Acenda, Inc. | Community/Behavioral Health | 168 E Broadway, Salem, NJ 08079-1153 | 2015-08-11 |
| 1265820880 | Leumas Lighted Life, LLC | Community/Behavioral Health | 32 W Clay St, Salem, VA 24153-3754 | 2015-01-05 |
| 1982004362 | Alternative Oppurtunities | Community/Behavioral Health | 684 Sky Vu Shopping Center, Highway 412 West, Salem, AR 72576 | 2014-09-04 |
| 1245646967 | Community Alternatives Virginia, Inc. | Community/Behavioral Health | 119 Sheraton Dr, Salem, VA 24153-3003 | 2014-07-02 |
| 1417361312 | Multi-cultural Consultants, Ltd | Community/Behavioral Health | Freedom & Recovery Program, 3405 Deer Park Dr. Se, Salem, OR 97310-0001 | 2014-06-18 |
| Find all providers in SALEM | ||||
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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.