COLUMBIACARE SERVICES (NPI# 1568779635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568779635 |
| Entity Type | Organization |
| Organization Name | COLUMBIACARE SERVICES |
| Other Organization Name | JOHNSON CREEK |
| Practice Address |
2808 Se Balfour St Milwaukie OR 97222-6426 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5036592575 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2010-09-09 |
| Authorized Official Name | MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5418588170 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | RESIDENTIAL PROVIDER | 500611338 | 01 |
| Other Name | Type Code |
|---|---|
| Johnson Creek | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427553692 | Columbiacare Services | Clinic/Center | 29415 Russell St, Gold Beach, OR 97444 | 2018-03-28 |
| 1255835104 | Columbiacare Services | Clinic/Center | 850 Swing Ln, Medford, OR 97501-1790 | 2018-03-23 |
| 1982140588 | Columbiacare Services | Clinic/Center | 17720 Ne Halsey St # 1, Portland, OR 97230-6734 | 2017-01-06 |
| 1831640192 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 8336 Highway 62, White City, OR 97530 | 2016-10-20 |
| 1871946640 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 29841 Hillcrest St, Gold Beach, OR 97444-8714 | 2016-07-18 |
| 1194173898 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 410 Maple St, Brookings, OR 97415 | 2016-06-03 |
| 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 |
| 1740679182 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 11380 Se Greenburg Rd #9, Tigard, OR 97223 | 2015-01-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | COLUMBIACARE SERVICES, INC | 3587 Heathrow Way, Medford, OR 97504 |
| Oregon Corporations, Companies and Business Names | COLUMBIACARE SERVICES, INC. | 3587 Heathrow Way, Medford, OR 97504 |
| Street Address |
2808 SE BALFOUR ST |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97222-6426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376680595 | James Heidrick | Counselor | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2007-01-30 |
| 1811526007 | Angie Bravo | Counselor | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2020-04-08 |
| 1407313869 | Cinnamon Merriss | Counselor | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2019-02-21 |
| 1780188540 | Tammy K Lofgren | Counselor | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2018-03-19 |
| 1629584529 | Mark Rioux | Peer Specialist | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2017-12-14 |
| 1699298901 | Mitchell Jones | Counselor | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2017-07-18 |
| 1467980342 | Melanie Atkison | Counselor | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2017-05-23 |
| 1386170835 | Melinda Del Rio | Counselor | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2017-05-03 |
| 1780121889 | Fatiya Dire | Counselor | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2017-01-26 |
| 1407200082 | Kevin Betancourt | Counselor | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2016-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| 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 |
|---|---|---|---|---|
| 1477832947 | Columbiacare Services | Psychiatric Residential Treatment Facility | 4199 Se King Rd, Milwaukie, OR 97222-5892 | 2011-08-15 |
| 1467685750 | Columbiacare Services | Psychiatric Residential Treatment Facility | 2808 Se Balfour St, Milwaukie, OR 97222-6426 | 2009-09-02 |
| 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.