ADOLESCENT DAY TREATMENT CENTER INC OF DOUGLAS COUNTY (NPI# 1629168166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629168166 |
| Entity Type | Organization |
| Organization Name | ADOLESCENT DAY TREATMENT CENTER INC OF DOUGLAS COUNTY |
| Other Organization Name | RIVERSIDE CENTER |
| Practice Address |
671 S.w. Main Winston OR 97496 |
| Mailing Address |
Po Box 2259 Winston OR 97496-2259 |
| Practice Telephone | 5416796129 |
| Mailing Telephone | 5416796129 |
| Mailing Fax Number | 5416795285 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. BONNA M MEYER (INTERIM DIRECTOR) |
| Authorized Official Telephone | 5416796129 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
CERTIFICATE APPR | OR | Ambulatory Health Care Facilities |
| X | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
CERTIFCATE OF AP | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 297927 | 05 | |
| OR | 297928 | 05 |
| Other Name | Type Code |
|---|---|
| Riverside Center | Doing Business As Name - Organization |
| Street Address |
671 S.W. MAIN |
| City | WINSTON |
| State | OR |
| Zip Code | 97496 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679957708 | Second Wind Mental Health Clinic | Clinic/Center | 11 Sw Brantley Drive, Winston, OR 97496 | 2015-07-18 |
| 1992951305 | Ronald Forrest Tribble | Dentist | 90 Nw Glenhart, Winston, OR 97496 | 2008-08-18 |
| 1396923884 | Karen S Triplett | Nurse Practitioner | 92 Nw Glenhart Ave, Winston, OR 97496 | 2008-02-06 |
| 1184610123 | Ronald F. Tribble, Dmd, PC | Dentist | 90 Nw Glenhart Ave, Winston, OR 97496 | 2005-09-26 |
| 1083016695 | Cora G Hart | Psychologist | 671 Sw Main St, Winston, OR 97496 | 2014-09-25 |
| 1912160169 | Kathryn Elizabeth Dailey | Social Worker | 671 Sw Main, Winston, OR 97496 | 2008-07-08 |
| 1912061755 | Adapt | Family Medicine | 671 Sw Main, Winston, OR 97496-0012 | 2006-12-19 |
| 1144426271 | Rebecca Lin Duffy | Nurse Practitioner | 311 Sw Main, Winston, OR 97496-0771 | 2007-06-25 |
| 1861843310 | Stacy J Nielsen, Lcsw, LLC | Community/Behavioral Health | 11 Sw Brantley Dr, Winston, OR 97496-4526 | 2016-06-27 |
| 1033462866 | Kathryn Vara | Registered Nurse | 77 Sw Brantley Dr, Winston, OR 97496-4526 | 2012-10-17 |
| Find all providers in zip 97496 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
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| 1740812809 | Inhousedoc, Inc. | Clinic/Center | 23334 Sw Saint Charles Way, Sherwood, OR 97140-9483 | 2020-02-06 |
| 1033740204 | Cascade Therapy Center, LLC | Clinic/Center | 4531 Se Belmont St Ste 106, Portland, OR 97215-1675 | 2020-01-28 |
| 1043861222 | Renewing Strength Counseling LLC | Clinic/Center | 4509 S 6th St Ste 310, Klamath Falls, OR 97603-4883 | 2019-09-27 |
| 1205338365 | Youth Era | Clinic/Center | 44 W Broadway Ste 225, Eugene, OR 97401-3071 | 2018-03-05 |
| 1730598038 | Benton County | Clinic/Center | 4077 Sw Research Way, Corvallis, OR 97333-1065 | 2014-08-12 |
| 1801177902 | Cascade Counseling and Assessment | Clinic/Center | 516 Se Morrison St Ste 705, Portland, OR 97214-2347 | 2011-09-01 |
| 1932435377 | County of Lincoln | Clinic/Center | 322 Ne Eads St, Newport, OR 97365-2819 | 2009-10-20 |
| 1760718100 | Lincoln County Health and Human Services | Clinic/Center | 320 Lower Crestline Dr., Waldport, OR 97394 | 2009-10-20 |
| 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.