COLUMBIACARE SERVICES (NPI# 1811078165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811078165 |
| Entity Type | Organization |
| Organization Name | COLUMBIACARE SERVICES |
| Other Organization Name | CREEKSIDE |
| Practice Address |
1021 W 9th St The Dalles OR 97058-1007 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-7499 |
| Practice Telephone | 5412981920 |
| Practice Fax Number | 5412981917 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2006-10-17 |
| 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 | 776 | OR | Residential Treatment Facilities |
| N | 385H00000X | Respite Care | 776 | OR | Respite Care Facility |
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 776 | OR | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MC SERVICE PMT | 515195 | 01 |
| OR | 276355 | 05 |
| Other Name | Type Code |
|---|---|
| Creekside | 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 |
1021 W 9TH ST |
| City | THE DALLES |
| State | OR |
| Zip Code | 97058-1007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124637954 | Sierra Dawn Lock | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2020-07-28 |
| 1811519945 | Melissa Kay Ash | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2020-05-12 |
| 1992337646 | Caitlan Anne Hefner | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2020-02-11 |
| 1689211260 | Maria Del Rocio Reyes Patino | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2019-12-03 |
| 1326682139 | Elsherie Faataga Long | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2019-11-05 |
| 1881243020 | Tara A Phillips | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2019-09-10 |
| 1366091506 | Jadin T Nipko | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2019-09-10 |
| 1811456031 | Danielle A Taylor | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2019-03-18 |
| 1992278469 | James R Maxwell | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2019-01-08 |
| 1447722285 | Shauna R Stephens | Counselor | 1021 W 9th St, The Dalles, OR 97058-1007 | 2018-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538646864 | Ashlee Kai Mcnamara | Behavior Technician | 2525 W 8th St., #34, The Dalles, OR 97058 | 2018-07-19 |
| 1548784689 | Mireya Moreno Ibarra | Behavior Technician | 401 East 3rd Street, Suite 101, The Dalles, OR 97058 | 2017-07-31 |
| 1407304991 | Joshua Seidel | Pharmacist | 515 Mt Hood St, The Dalles, OR 97058 | 2016-09-14 |
| 1366809048 | Mid-columbia Medical Center | Surgery | 1810 E. 19th St. #225, The Dalles, OR 97058 | 2016-01-26 |
| 1558731141 | Louise Goodnight | Case Manager/Care Coordinator | 419 East 7 Th Street, The Dalles, OR 97058 | 2015-09-25 |
| 1578944666 | Jessica Donnell | Dental Hygienist | 2529 E 12th St, The Dalles, OR 97058 | 2015-06-15 |
| 1487034328 | Savanna Schaan | Specialist | 609 W 14th St, The Dalles, OR 97058 | 2015-06-05 |
| 1801299102 | Mary E Zenorini | Social Worker | 1620 E. 12th St, The Dalles, OR 97058 | 2014-09-30 |
| 1669889143 | Diane Joan Irwin | Social Worker | 419 E 7th St #207, The Dalles, OR 97058 | 2014-07-17 |
| 1124452008 | Lacey A Nichols | Counselor | 312 E. Third St., The Dalles, OR 97058 | 2013-08-27 |
| Find all providers in zip 97058 | ||||
| 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 |
|---|---|---|---|---|
| 1932714581 | Elderly and Disabled Services | Psychiatric Residential Treatment Facility | 248 Mace Rd, Medford, OR 97501-1280 | 2020-09-10 |
| 1144761784 | Lifeways, Inc | Psychiatric Residential Treatment Facility | 1212 W Linda Ave, Hermiston, OR 97838-6946 | 2017-03-15 |
| 1679959761 | Candice Ann Hopper | Psychiatric Residential Treatment Facility | 16326 Butteville Rd Ne, Woodburn, OR 97071-8408 | 2015-07-31 |
| 1568883254 | Columbiacare Services | Psychiatric Residential Treatment Facility | 2575 Westgate Bldg F, Pendleton, OR 97801-9613 | 2013-12-23 |
| 1477974293 | Columbiacare Services | Psychiatric Residential Treatment Facility | 2575 Westgate Bldg E, Pendleton, OR 97801-9613 | 2013-12-20 |
| 1235440702 | Trillium Family Services | Psychiatric Residential Treatment Facility | 3009 Nw Grant Pl, Corvallis, OR 97330-1814 | 2010-06-29 |
| 1346494101 | Trillium Family Services | Psychiatric Residential Treatment Facility | 229 Se 4th Ave, Albany, OR 97321 | 2008-11-06 |
| 1881851186 | Columbiacare Services | Psychiatric Residential Treatment Facility | 12501 Se Raymond St, Portland, OR 97236-3931 | 2008-05-22 |
| 1831395375 | Trillium Family Services | Psychiatric Residential Treatment Facility | 2430 Nw Rolling Green Dr, #17, Corvallis, OR 97330-3778 | 2007-06-22 |
| 1962607549 | Children's Farm Home | Psychiatric Residential Treatment Facility | 954 Nw Sycamore Ave, Apt 8, Corvallis, OR 97330-7107 | 2007-06-15 |
| Find all providers with the same taxonomy | ||||
| City | THE DALLES |
| Zip Code | 97058 |
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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.