DRAGONFLY PROGRAMS, LLC (NPI# 1811541568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811541568 |
| Entity Type | Organization |
| Organization Name | DRAGONFLY PROGRAMS, LLC |
| Other Organization Name | DRAGONFLY TRANSITIONS |
| Practice Address |
505 N 9th St Klamath Falls OR 97601-2876 |
| Mailing Address |
5500 Ming Ave Ste 265 Bakersfield CA 93309-4689 |
| Practice Telephone | 5418500841 |
| Practice Fax Number | 8663413053 |
| Mailing Telephone | 6618294060 |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-04-07 |
| Authorized Official Name | MRS. LAURIE BROWN (VP OF REVENUE CYCLE MANAGEMENT) |
| Authorized Official Telephone | 6618294060 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHANGE ACADEMY AT LAKE OF THE OZARKS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Dragonfly Transitions | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | DRAGONFLY PROGRAMS, LLC | 2177 E Warner Rd #101, Tempe, AZ 85284 |
| Street Address |
505 N 9TH ST |
| City | KLAMATH FALLS |
| State | OR |
| Zip Code | 97601-2876 |
| 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 | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740844984 | Brigacare, Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 15703 Sw Whetstone Way, Sherwood, OR 97140-8895 | 2019-04-23 |
| 1275085128 | Northwest Youth Discovery | Residential Treatment Facility, Emotionally Disturbed Children | 61850 Dobbin Rd, Bend, OR 97702-9536 | 2016-10-26 |
| 1427414895 | Polk Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 175 Ne Kings Valley Hwy Ste A, Dallas, OR 97338-1787 | 2016-01-14 |
| 1083070361 | Oregon 180 | Residential Treatment Facility, Emotionally Disturbed Children | 725 W 14th St, Medford, OR 97501-3429 | 2016-01-03 |
| 1013395953 | Bridges Academy Corp | Residential Treatment Facility, Emotionally Disturbed Children | 67030 Gist Rd, Bend, OR 97701-9209 | 2015-05-12 |
| 1336565993 | Northwest Youth Discovery | Residential Treatment Facility, Emotionally Disturbed Children | 9 Nw 15th St, Bend, OR 97701-3102 | 2014-03-06 |
| 1528499696 | Klamath Lake County Youth Ranch | Residential Treatment Facility, Emotionally Disturbed Children | 5800 Happy Hollow Ln, Bonanza, OR 97623-7714 | 2013-11-27 |
| 1487082681 | Yamhill County Juvenile Department | Residential Treatment Facility, Emotionally Disturbed Children | 535 E 5th St, Mcminnville, OR 97128-4504 | 2013-10-24 |
| 1154758266 | Youth Guidance Association | Residential Treatment Facility, Emotionally Disturbed Children | 2730 Ne Flanders St, Portland, OR 97232-3160 | 2013-10-03 |
| 1306288071 | The Inn, Home for Boys | Residential Treatment Facility, Emotionally Disturbed Children | 8940 Se 72nd Ave, Portland, OR 97206-9417 | 2013-07-23 |
| 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.