KLAMATH CHILD AND FAMILY TREATMENT CENTER (NPI# 1003296740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003296740 |
| 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 | 5418831028 |
| Mailing Telephone | 5418831028 |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2016-12-13 |
| Authorized Official Name | NENA INMAN (RESIDENTIAL SPECIALIST) |
| Authorized Official Telephone | 5418872391 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 172V00000X | OR | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NON PROFIT | 172V00000X | 01 |
| Other Name | Type Code |
|---|---|
| Klamath Youth Development Center | Other Name - Individual/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 |
| 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 |
|---|---|---|---|---|
| 1902830524 | Klamath Child and Family Treatment Center | Voluntary or Charitable | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2006-07-10 |
| 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 |
| 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 | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376188896 | Thomas Wayne Stutzman | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 168 Ackerman St E, Monmouth, OR 97361-2214 | 2019-11-07 |
| 1710539119 | Kathy Bailey | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4840 Patricia Ct Ne, Salem, OR 97305-3313 | 2019-07-15 |
| 1255893988 | Ariel Schmidt | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3658 Wiltsey St Se, Salem, OR 97317-9303 | 2019-04-02 |
| 1588921845 | Haven House Treatment Center Corp | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 13565 Sw Singletree Dr, Beaverton, OR 97008-7517 | 2012-04-11 |
| 1407121106 | Sean's Place, Incorporated | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 930 Hammer St, Harrisburg, OR 97446-9590 | 2012-03-13 |
| 1457561524 | Childerns Farm Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2820 Se Glenn St, Corvallis, OR 97333-2121 | 2007-05-23 |
| 1811064447 | Alternative Services Oreogn, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11830 Kerr Pkwy, Suite 210, Lake Oswego, OR 97035-1249 | 2006-11-29 |
| 1720023807 | Dept. of Human Srvcs/office of Fin. Srvcs Dba: Irs/eopc/eotc/osh/osh-p | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2525 Westgate, Pendleton, OR 97801-9613 | 2006-06-20 |
| 1043876865 | Home Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5100 Center St Ne, Salem, OR 97317-3217 | 2019-05-16 |
| 1164979191 | Stoneybrooke Residential Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 25500 Se Stark St, Suite 101, Gresham, OR 97030-3331 | 2016-09-07 |
| Find all providers with the same taxonomy | ||||
| City | KLAMATH FALLS |
| Zip Code | 97601 |
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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.