KLAMATH CHILD AND FAMILY TREATMENT CENTER (NPI# 1902830524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902830524 |
| Entity Type | Organization |
| Organization Name | KLAMATH CHILD AND FAMILY TREATMENT CENTER |
| Other Organization Name | KLAMATH YOUTH DEVELOPMENT CENTER |
| Practice Address |
2210 N Eldorado Ave Klamath Falls OR 97601-6418 |
| Practice Telephone | 5418831030 |
| Practice Fax Number | 5418842338 |
| Mailing Telephone | 5418831030 |
| Mailing Fax Number | 5418842338 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. STANLEY DALE GILBERT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5418831030 |
| Authorized Official Credential | LPC, LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251V00000X | Voluntary or Charitable | OR | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 223354 | 05 |
| Other Name | Type Code |
|---|---|
| Klamath Youth Development Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861863409 | Klamath Child and Family Treatment Center | Community/Behavioral Health | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2015-10-08 |
| 1003296740 | Klamath Child and Family Treatment Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2015-06-08 |
| 1992949796 | Klamath Child and Family Treatment Center | Community Based Residential Treatment Facility, Mental Illness | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2009-04-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | KLAMATH CHILD AND FAMILY TREATMENT CENTER, INC. | 2210 Eldorado Ave, Klamath Falls, OR 97601 |
| Street Address |
2210 N ELDORADO AVE |
| City | KLAMATH FALLS |
| State | OR |
| Zip Code | 97601-6418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051524 | Anthony Victor Anghinetti | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-10-20 |
| 1013514827 | Kassie Anderson | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-10-05 |
| 1821604828 | Ryan Matthew Conrady | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-16 |
| 1730795733 | Joy June Hobbs | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-16 |
| 1821603762 | Alejandra Avalos Vasquez | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-08 |
| 1154935542 | Deanna Kay Garren | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-02 |
| 1619581006 | Meghan Rae Gorbett | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-02 |
| 1710595160 | Katrina V Hopf | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-07-21 |
| 1104434554 | Laurie Rae Cooper | Counselor | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-07-21 |
| 1861017360 | Christina Lynn Martinez | Counselor | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205487311 | Socorro Guadalupe Alcala- Peres | Case Manager/Care Coordinator | 2210 N El Dorado Ave, Klamath Falls, OR 97601 | 2019-09-20 |
| 1033760053 | Melissa Ann Roy | Counselor | 2210 North El Dorado, 2210 North El Dorado, Klamath Falls, OR 97601 | 2019-09-20 |
| 1134699721 | Kristin Asta Ragnarsson | Speech-Language Pathologist | Plum Ridge Care 1401 Bryant Williams, Klamath Falls, OR 97601 | 2018-11-27 |
| 1730667445 | Nancy Leota Baley | Pharmacist | Sky Lakes Outpatient Pharmacy, 2865 Daggett Street, Klamath Falls, OR 97601 | 2018-08-03 |
| 1336511260 | Patricia Blauvelt | Occupational Therapy Assistant | 1401 Bryant Williams Dr, Klamath Falls, OR 97601 | 2015-10-30 |
| 1598160814 | Christopher S. Turner | Counselor | 635 Main St., Klamath Falls, OR 97601 | 2014-10-29 |
| 1134472582 | Whole Person Care Family Practice | Family Medicine | 2301 Mountainview Blvd. Ste B, Klamath Falls, OR 97601 | 2012-10-23 |
| 1255692687 | Billy Dean Vermaas | Physical Medicine & Rehabilitation | 204 N. 10th Street, Klamath Falls, OR 97601 | 2012-06-01 |
| 1407140700 | Wendell C Heidinger Md | Family Medicine | 2301 Clairmont Drive, Klamath Falls, OR 97601 | 2011-06-03 |
| 1740573146 | Klamath Youh Department Center | Community/Behavioral Health | 2210 Eldordo Ave, Klamath Falls, OR 97601 | 2011-05-18 |
| Find all providers in zip 97601 | ||||
| Taxonomy Code | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
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| 1487070181 | United Community Action Network | Voluntary or Charitable | 280 Ne Kenneth Ford Dr, Roseburg, OR 97470-1034 | 2014-03-05 |
| Find all providers with the same taxonomy | ||||
| City | KLAMATH FALLS |
| Zip Code | 97601 |
Please comment or provide details below to improve the information on KLAMATH CHILD AND FAMILY TREATMENT CENTER.
| 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.