TRILLIUM FAMILY SERVICE (NPI# 1275734485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275734485 |
| Entity Type | Organization |
| Organization Name | TRILLIUM FAMILY SERVICE |
| Practice Address |
4455 Ne Highway 20 Corvallis OR 97330-9695 |
| Mailing Address |
1300 Sw E Ave Apt #104 Corvallis OR 97333-4077 |
| Practice Telephone | 5417585909 |
| Mailing Telephone | 5038886914 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DANIEL WOLF (CATS) |
| Authorized Official Telephone | 5417585909 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538570551 | Trillium Family Service | Residential Treatment Facility, Emotionally Disturbed Children | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2014-05-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | TRILLIUM FAMILY SERVICES FOUNDATION, INC. | 3415 Se Powell Blvd, Portland, OR 97202 |
| Oregon Corporations, Companies and Business Names | TRILLIUM FAMILY SERVICES, INC. | 3415 Se Powell Blvd, Portland, OR 97202 |
| Street Address |
4455 NE HIGHWAY 20 |
| City | CORVALLIS |
| State | OR |
| Zip Code | 97330-9695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790884690 | Timothy Joseph Catlow | Psychologist | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2006-09-21 |
| 1609477561 | Brock Van Dyke | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2020-11-05 |
| 1518568476 | Julia Di Simone | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2020-11-05 |
| 1336740299 | Sabrina Michelle Watkins | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2020-11-05 |
| 1245831106 | Hope Trautman | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2020-11-05 |
| 1932700028 | Hayley Boss | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2020-11-04 |
| 1477154714 | Ashley Merback | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2020-11-03 |
| 1396346631 | Mikayla Alberta Calvery | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2020-11-03 |
| 1750982096 | Christine Turner | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2020-11-03 |
| 1831790179 | Madison Elysse Weekly | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2020-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754912 | Miya Claborn | Counselor | 4495 Se Hwy 20, Corvallis, OR 97330 | 2020-06-09 |
| 1548889017 | Greydi Olvera | Counselor | Childrens Farm Home 4455 Ne Hwy 20, Corvallius, OR 97330 | 2020-04-14 |
| 1053953992 | Andie Marie Gaipo | Counselor | 4455 Ne Hwy 20 - Children's Farm Home, Corvallis, OR 97330 | 2019-10-11 |
| 1740847177 | Stephen Jack Eccles | Behavior Technician | Trillium Children's Farm Home, 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-05-21 |
| 1750944815 | Tiffany Rene Flinchpaugh | Counselor | Children's Farm Home 4455 Hwy 20, Corvallis, OR 97330 | 2019-04-15 |
| 1679035455 | Isaiah Mile Cassidy | Counselor | Children's Farm Home-4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-04-02 |
| 1982168399 | Haylee Cramblit | Counselor | Children's Farm Home 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-01-30 |
| 1457835365 | Ashley Alyn Couch | Counselor | 4455 Hwy 20 Corvallis 97330, Corvallis, OR 97330 | 2018-09-18 |
| 1104318898 | Megan Gerding | Technician, Other | 996 Nw Circle Blvd Suite 103, Corvallis, OR 97330 | 2018-05-30 |
| 1700377108 | Pacific Hearing Services | Audiologist | 975 Nw Spruce Ave, Suite #101, Corvallis, OR 97330 | 2018-05-22 |
| Find all providers in zip 97330 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184829194 | Childrens Farm Home | Residential Treatment Facility, Emotionally Disturbed Children | 4455 N.e.hwy 20, Corvallis, OR 97330 | 2007-06-19 |
| 1568663300 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 4140 Ne Highway 20, Corvallis, OR 97330-9639 | 2007-05-30 |
| 1366643579 | Children's Farm Home | Residential Treatment Facility, Emotionally Disturbed Children | 3280 Ne Lancaster St Apt 2, Corvallis, OR 97330-4059 | 2007-05-29 |
| 1619178829 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 4455 Highway North West Highway 20, Corvallis, OR 97333 | 2007-05-29 |
| 1356552558 | Children's Farm Home | Residential Treatment Facility, Emotionally Disturbed Children | 1355 Sw Western Blvd, Corvallis, OR 97333-4203 | 2007-05-27 |
| 1760827182 | Children Farm Home | Residential Treatment Facility, Emotionally Disturbed Children | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2013-04-30 |
| 1942401781 | Childrens Farm Home | Residential Treatment Facility, Emotionally Disturbed Children | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2007-05-30 |
| 1922209121 | Trillium Family Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4455 Ne Hwy 20, Corvallis, OR 97330-9695 | 2007-05-29 |
| 1992873004 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 4455 Ne Highway 20, Corvallis, OR 97330 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811541568 | Dragonfly Programs, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 505 N 9th St, Klamath Falls, OR 97601-2876 | 2019-07-31 |
| 1740844984 | Brigacare, Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 15703 Sw Whetstone Way, Sherwood, OR 97140-8895 | 2019-04-23 |
| 1275085128 | Northwest Youth Discovery | Residential Treatment Facility, Emotionally Disturbed Children | 61850 Dobbin Rd, Bend, OR 97702-9536 | 2016-10-26 |
| 1427414895 | Polk Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 175 Ne Kings Valley Hwy Ste A, Dallas, OR 97338-1787 | 2016-01-14 |
| 1083070361 | Oregon 180 | Residential Treatment Facility, Emotionally Disturbed Children | 725 W 14th St, Medford, OR 97501-3429 | 2016-01-03 |
| 1013395953 | Bridges Academy Corp | Residential Treatment Facility, Emotionally Disturbed Children | 67030 Gist Rd, Bend, OR 97701-9209 | 2015-05-12 |
| 1336565993 | Northwest Youth Discovery | Residential Treatment Facility, Emotionally Disturbed Children | 9 Nw 15th St, Bend, OR 97701-3102 | 2014-03-06 |
| 1528499696 | Klamath Lake County Youth Ranch | Residential Treatment Facility, Emotionally Disturbed Children | 5800 Happy Hollow Ln, Bonanza, OR 97623-7714 | 2013-11-27 |
| 1487082681 | Yamhill County Juvenile Department | Residential Treatment Facility, Emotionally Disturbed Children | 535 E 5th St, Mcminnville, OR 97128-4504 | 2013-10-24 |
| 1154758266 | Youth Guidance Association | Residential Treatment Facility, Emotionally Disturbed Children | 2730 Ne Flanders St, Portland, OR 97232-3160 | 2013-10-03 |
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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.