KLAMATH TRIBAL HEALTH & FAMILY SERVICES (NPI# 1578864641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578864641 |
| Entity Type | Organization |
| Organization Name | KLAMATH TRIBAL HEALTH & FAMILY SERVICES |
| Other Organization Name | KLAMATH YOUTH REGIONAL TREATMENT CENTER |
| Practice Address |
121 Iowa St. Klamath Falls OR 97601 |
| Mailing Address |
3949 South 6th St. Klamath Falls OR 97603-4746 |
| Practice Telephone | 5418821487 |
| Practice Fax Number | 5418821670 |
| Mailing Telephone | 5418821487 |
| Mailing Fax Number | 5418821670 |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |
| Authorized Official Name | LEROY JACKSON JR. (HEALTH GENERAL MANAGER) |
| Authorized Official Telephone | 5418821487 |
| Is Organization Subpart | Y |
| Parent Organization Name | KLAMATH TRIBAL HEALTH & FAMILY SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Klamath Youth Regional Treatment Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629078274 | Klamath Tribal Health & Family Services | Clinic/Center | 330 Chiloquin Blvd, Chiloquin, OR 97624 | 2005-07-26 |
| 1639290778 | Klamath Tribal Health & Family Services | Pharmacy | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2007-04-03 |
| Street Address |
121 IOWA ST. |
| City | KLAMATH FALLS |
| State | OR |
| Zip Code | 97601 |
| 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 | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467885145 | Klamath County Juvenile Department | Substance Abuse Rehabilitation Facility | 3331 Vandenberg Rd, Klamath Falls, OR 97603-3730 | 2013-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740543297 | Marion County Health Department | Substance Abuse Rehabilitation Facility | 3529 Fisher Rd Ne, Salem, OR 97305 | 2012-06-20 |
| 1972864759 | New Directions Northwest, Inc. | Substance Abuse Rehabilitation Facility | 3700 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
| 1023322690 | The Northstar Center | Substance Abuse Rehabilitation Facility | 1195 Nw Wall St, Bend, OR 97701-1965 | 2010-08-05 |
| 1811215478 | Rimrock Trails Adolescent Treatment Services | Substance Abuse Rehabilitation Facility | 16360 1st Street, La Pine, OR 97739-0305 | 2010-05-06 |
| 1730362534 | Adapt | Substance Abuse Rehabilitation Facility | 2064 Se Douglas Ave, Roseburg, OR 97470-3713 | 2007-12-14 |
| 1821205246 | Gail Renee Wilson | Substance Abuse Rehabilitation Facility | 2614 Se 115th Ave Apt 2, Portland, OR 97266-1176 | 2007-05-16 |
| 1851753123 | Dalana Sewell | Substance Abuse Rehabilitation Facility | 234 W 5th St, Medford, OR 97501-2611 | 2016-03-24 |
| 1225403744 | Looking Glass Community Services - Pathways Boys | Substance Abuse Rehabilitation Facility | 550 River Rd, Eugene, OR 97404-3212 | 2015-12-09 |
| 1265866305 | Hillcrest Youth Correctional Facility-oregon Youth Authority | Substance Abuse Rehabilitation Facility | 2450 Strong Rd Se, Salem, OR 97302-9676 | 2013-08-26 |
| 1396186607 | Richard Ivan Vaughan | Substance Abuse Rehabilitation Facility | 4310 Ne Killingsworth St, Portland, OR 97208-3007 | 2013-07-15 |
| 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.