COLUMBACARE SERVICES (NPI# 1679073712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679073712 |
| Entity Type | Organization |
| Organization Name | COLUMBACARE SERVICES |
| Other Organization Name | SUMMIT RESIDENTIAL SOUTH |
| Practice Address |
622 57th St Springfield OR 97478-6821 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5418588170 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2018-02-15 |
| 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 |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Summit Residential South | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1346855624 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 17710 Ne Halsey St, Portland, OR 97230-6734 | 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 |
622 57TH ST |
| City | SPRINGFIELD |
| State | OR |
| Zip Code | 97478-6821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588225155 | Mckenzie Dental Center | Dentist | 110 S. 59th St, Springfield, OR 97478 | 2019-06-25 |
| 1831691310 | Michael Ryan Odle | Psychologist | 36716 Oak Point Rd, Springfield, OR 97478 | 2018-03-01 |
| 1639612880 | Icco LLC | Clinic/Center | 5781 Main Street, Springfield, OR 97478 | 2016-11-21 |
| 1639529258 | Nate John Sutherland | Behavioral Analyst | 37770 Upper Creek Road, Springfield, OR 97478 | 2016-06-14 |
| 1457760134 | Leah Rybolt | Physical Therapist | 145 South 52nd Place, Springfield, OR 97478 | 2014-08-07 |
| 1972918423 | Loree Lynn Howard | Case Manager/Care Coordinator | 4145 Jasper Road, Springfield, OR 97478 | 2014-06-24 |
| 1245589753 | Sarah M Boothe | Doula | 870 S 46th St, Springfield, OR 97478 | 2012-08-30 |
| 1902155401 | Dani Maree Hill | Pharmacist | 5744 Main Street, Springfield, OR 97478 | 2012-08-30 |
| 1295005312 | Express Services Unlimited, Inc. | Non-emergency Medical Transport (VAN) | 37506 Hills Creek Road, Springfield, OR 97478 | 2012-01-05 |
| 1255524468 | Leeann D Fields | Licensed Practical Nurse | 3318 Lakeview Dr, Eugene, OR 97478 | 2007-08-21 |
| Find all providers in zip 97478 | ||||
| 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 |
|---|---|---|---|---|
| 1164740734 | Youth Service International Inc. | Psychiatric Residential Treatment Facility | 709 6th Street, Springfield, SD 57062 | 2010-05-06 |
| 1720165327 | Lakeland Hospital Acquisition, LLC | Psychiatric Residential Treatment Facility | 440 South Market Ave, Springfield, MO 65806-2026 | 2006-11-01 |
| 1861897183 | Columbiacare Services | Psychiatric Residential Treatment Facility | 2211 Clear Vue Ln, Springfield, OR 97477-1373 | 2014-10-29 |
| 1417214636 | Great Circle | Psychiatric Residential Treatment Facility | 1212 W Lombard St, Springfield, MO 65806-2720 | 2012-04-12 |
| 1205095569 | Lakeland Hospital Acquisition, LLC | Psychiatric Residential Treatment Facility | 440 S Market Ave, Springfield, MO 65806-2026 | 2008-06-03 |
| 1295801678 | Boys & Girls Town of Missouri | Psychiatric Residential Treatment Facility | 1212 W Lombard St, Springfield, MO 65806-2720 | 2006-11-28 |
| 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 | ||||
| City | SPRINGFIELD |
| Zip Code | 97478 |
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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.