PELTON PROJECT, INC. (NPI# 1053559765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053559765 |
| Entity Type | Organization |
| Organization Name | PELTON PROJECT, INC. |
| Other Organization Name | PELTON PROJECT |
| Practice Address |
714 Lost Ln N Keizer OR 97303-6335 |
| Mailing Address |
Po Box 21748 Keizer OR 97307-1748 |
| Practice Telephone | 5034636499 |
| Practice Fax Number | 5033042224 |
| Mailing Telephone | 5417607851 |
| Mailing Fax Number | 5033042224 |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2019-07-02 |
| Authorized Official Name | CHAD STEVENS (CEO) |
| Authorized Official Telephone | 5036894866 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Pelton Project | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PELTON PROJECT, INC. | 714 Lost Ln N, Keizer, OR 97303-6335 |
| Oregon Corporations, Companies and Business Names | PELTON PROJECT, INC. | 714 Lost Lane N, Keizer, OR 97303 |
| Street Address |
714 LOST LN N |
| City | KEIZER |
| State | OR |
| Zip Code | 97303-6335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649750175 | Kristin Marie Barz | Behavioral Analyst | 4690 12th Ave Ne, Keizer, OR 97303 | 2018-08-15 |
| 1003359605 | Angela Rose Richard | Community Health Worker | 3410 Cherry Avenue Ne, Keizer, OR 97303 | 2016-11-30 |
| 1881146629 | Alma Denise Vera | Dental Hygienist | 5825 Shoreview Lane Ste C, Keizer, OR 97303 | 2016-10-27 |
| 1679919849 | Ramya Shyamala Kamath | Dentist | 4817 River Rd N, Keizer, OR 97303 | 2013-05-15 |
| 1356682041 | Teresa M Treinen | Physical Therapist | 190 Sandy Drive N, Keizer, OR 97303 | 2013-03-06 |
| 1598001844 | Eagle Eye Vision Care LLC | Optometrist | 4048 River Road North, Keizer, OR 97303 | 2012-12-13 |
| 1245590553 | Thora Jane Stacy | Dental Assistant | 2300 N.e. Lacncaster Dr., Salem, OR 97303 | 2012-05-21 |
| 1295028850 | Rodger Nordskog Magnuson | Pharmacist | 5452 River Road N., Keizer, OR 97303 | 2011-05-16 |
| 1326299843 | Douglas Scott Hamblin | Pediatrics | 5685 Inland Shores Way, Keizer, OR 97303 | 2008-10-02 |
| 1982870382 | Debra Kaye Lynch | Podiatrist | 4905 River Road N, Keizer, OR 97303 | 2008-05-06 |
| Find all providers in zip 97303 | ||||
| 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 | ||||
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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.