COLUMBACARE SERVICES (NPI# 1346855624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346855624 |
| Entity Type | Organization |
| Organization Name | COLUMBACARE SERVICES |
| Practice Address |
17710 Ne Halsey St Portland OR 97230-6734 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5418588170 |
| Mailing Telephone | 5418588170 |
| Enumeration Date | 2020-09-13 |
| Last Update Date | 2020-09-13 |
| Authorized Official Name | MICHAEL SEWITSKY (FINANCE DIRECTOR) |
| Authorized Official Telephone | 5418588170 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Halsey Street SRTF | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679073712 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 622 57th St, Springfield, OR 97478-6821 | 2018-02-15 |
| 1518201151 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 210 Cove Lane, Brookings, OR 97415 | 2012-11-20 |
| 1619582996 | Columbacare Services | Clinic/Center | 1057 Patterson St, Eugene, OR 97401-3315 | 2020-09-13 |
| 1629603196 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 70362 Kunze Ln, Boardman, OR 97818-8013 | 2020-03-05 |
| 1508420076 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 29398 Recovery Way, Junction City, OR 97448-8442 | 2019-04-30 |
| 1942762547 | Columbacare Services | Psychiatric Residential Treatment Facility | 29398 Recovery Way Ste 3, Junction City, OR 97448-8442 | 2019-04-02 |
| 1902374531 | Columbacare Services | Clinic/Center | 3200 Juanipero Way, Medford, OR 97504 | 2018-11-13 |
| 1992223630 | Columbacare Services | Clinic/Center | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2017-09-01 |
| 1841718574 | Columbacare Services | Clinic/Center | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2017-09-01 |
| Street Address |
17710 NE HALSEY ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-6734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619015617 | Lanorma Burrell | Counselor | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2007-02-02 |
| 1902457666 | Jordyn Lair | Counselor | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2019-09-24 |
| 1871069179 | Annabell M Landis | Counselor | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2018-10-15 |
| 1891276713 | Elizabeth A Martinez | Counselor | 17710 Ne Halsey St, Portland, OR 97230 | 2018-08-28 |
| 1528554078 | Latasha S Hunt | Counselor | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2018-07-09 |
| 1134629769 | Travis W Ray | Counselor | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2018-02-20 |
| 1861909681 | Cody Solis | Counselor | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2018-01-02 |
| 1376072454 | Geraldina Cintron | Counselor | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2017-06-12 |
| 1427418797 | Tara Gonzales | Counselor | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2016-03-01 |
| 1073972485 | Rachel Gill | Counselor | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2016-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| Find all providers in zip 97230 | ||||
| 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 |
|---|---|---|---|---|
| 1558732966 | John William Thompson | Community Based Residential Treatment Facility, Mental Illness | 5538 Ne 24th Ave, Portland, OR 97211-6206 | 2015-10-12 |
| 1679941785 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 130 Se 119th Ave, Portland, OR 97216-3704 | 2015-09-04 |
| 1346637816 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17710 Halsey Crc, Portland, OR 97230 | 2015-04-22 |
| 1700273638 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17700 Ne Halsey St, Portland, OR 97230-6734 | 2015-04-17 |
| 1447654504 | Cascadia Behavioral Health Care | Community Based Residential Treatment Facility, Mental Illness | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-10-20 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1821491853 | Florence Mutie | Community Based Residential Treatment Facility, Mental Illness | 5123 Sw 62nd Ave, Portland, OR 97221-1170 | 2014-10-05 |
| 1679983381 | Janus Youth Program | Community Based Residential Treatment Facility, Mental Illness | 142 Se 160th Ave Apt 24, Portland, OR 97233-3558 | 2014-05-02 |
| 1558606384 | Renew Consulting, Inc. | Community Based Residential Treatment Facility, Mental Illness | 12810 Sw 62nd Ave, Portland, OR 97219-8034 | 2012-12-05 |
| 1558686576 | Mentor Abi | Community Based Residential Treatment Facility, Mental Illness | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2010-04-01 |
| Find all providers in PORTLAND | ||||
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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.