KLAMATH CHILD AND FAMILY TREATMENT CENTER (NPI# 1992949796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992949796 |
| Entity Type | Organization |
| Organization Name | KLAMATH CHILD AND FAMILY TREATMENT CENTER |
| Other Organization Name | PHOENIX PLACE |
| Practice Address |
725 Washburn Way Klamath Falls OR 97603-3648 |
| Mailing Address |
2210 N Eldorado Klamath Falls OR 97601-6418 |
| Practice Telephone | 5418831030 |
| Practice Fax Number | 5418842338 |
| Mailing Telephone | 5418831030 |
| Mailing Fax Number | 5418842338 |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2015-01-16 |
| Authorized Official Name | MRS. ELIZABETH MADDALENA (DIRECTOR OF OPERATIO) |
| Authorized Official Telephone | 5418831030 |
| Is Organization Subpart | Y |
| Parent Organization Name | KLAMATH MENTAL HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | OR | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500500017 | 05 |
| Other Name | Type Code |
|---|---|
| Phoenix Place | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902830524 | Klamath Child and Family Treatment Center | Voluntary or Charitable | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2006-07-10 |
| 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 |
| 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 |
725 WASHBURN WAY |
| City | KLAMATH FALLS |
| State | OR |
| Zip Code | 97603-3648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336292408 | Diane Putnam | Counselor | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2007-01-19 |
| 1013393289 | Rebecca Ruth Pierce | Community Health Worker | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2015-08-10 |
| 1700262326 | Heidi Guajardo | Community Health Worker | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2015-08-05 |
| 1679959589 | Londa Bowen | Community Health Worker | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2015-08-03 |
| 1629458021 | William Barnes | Counselor | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2015-06-02 |
| 1699173971 | Amanda Whitson | Specialist | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2014-12-18 |
| 1457759110 | Kristi Gallagher | Community Health Worker | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2014-12-11 |
| 1912334947 | Michele B Medina | Counselor | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2013-10-04 |
| 1013343565 | Robin Lea Jordan | Licensed Practical Nurse | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2013-09-16 |
| 1669805263 | Sherri Misiasz | Community Health Worker | 725 Washburn Way, Klamath Falls, OR 97603-3648 | 2013-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790323699 | Mike Hampson | Counselor | 3203 Vandenberg Road, Klamath Falls, OR 97603 | 2019-12-11 |
| 1356858369 | Scott Richardson | Community Based Residential Treatment Facility, Mental Illness | 3934 Rio Vista Way, Klamath Falls, OR 97603 | 2017-12-29 |
| 1720518392 | Maile Kalus | Counselor | 3647 Or-39, Klamath Falls, OR 97603 | 2017-06-15 |
| 1174067201 | Amber Wu | Audiologist | 4036 S 6th St Ste 3, Klamath Falls, OR 97603 | 2016-12-08 |
| 1568870681 | Nathan William Bailey | Dentist | 2301 Mountain View Blvd, Suite D, Klamath Falls, OR 97603 | 2014-08-01 |
| 1376987784 | Janice Marie Heiney | Denturist | 2607 Crosby Ave, Klamath Falls, OR 97603 | 2013-04-29 |
| 1083958011 | John W Cooper | Denturist | 3949 Shasta Way, Klamath Falls, OR 97603 | 2012-11-15 |
| 1205137742 | Robert Knight | Community Health Worker | 3314 Vandenburg Rd., Klamath Falls, OR 97603 | 2010-11-16 |
| 1841526431 | Tim R Jones | Counselor | 3949 South 6th St, Klamath Falls, OR 97603 | 2009-11-02 |
| 1316135833 | Ernest Thompson O'neal | Emergency Medicine | 211 Arnold Ave. Ste 15, Klamath Falls, OR 97603 | 2007-10-10 |
| Find all providers in zip 97603 | ||||
| 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 |
|---|---|---|---|---|
| 1356858369 | Scott Richardson | Community Based Residential Treatment Facility, Mental Illness | 3934 Rio Vista Way, Klamath Falls, OR 97603 | 2017-12-29 |
| 1053563403 | Dragonfly Adventures, Inc | Community Based Residential Treatment Facility, Mental Illness | 919 High St, Klamath Falls, OR 97601-2830 | 2008-10-16 |
| 1962883793 | Elizabeth Panuco | Community Based Residential Treatment Facility, Mental Illness | 121 Iowa St, Klamath Falls, OR 97601-1606 | 2015-06-17 |
| 1396172375 | Klamath Youth Development Center | Community Based Residential Treatment Facility, Mental Illness | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2013-10-04 |
| 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 |
| 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 |
| 1740733906 | Trillium Family Services | Community Based Residential Treatment Facility, Mental Illness | 4545 Ne Highway 20, Corvallis, OR 97330-9655 | 2016-07-25 |
| Find all providers with the same taxonomy | ||||
| City | KLAMATH FALLS |
| Zip Code | 97603 |
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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.