COMMUNITY OUTREACH INC NPI 1235341918

NPI Information

NPI: 1235341918
Provider Name: COMMUNITY OUTREACH, INC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 38D0965932

Address:
865 NW REIMAN AVE
CORVALLIS, OR
ZIP 97330
Phone: (541) 758-3000
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COMMUNITY OUTREACH, INC is an addiction (substance use disorder) counselor in Corvallis, OR. COMMUNITY OUTREACH, INC NPI is 1235341918. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

865 NW REIMAN AVE
CORVALLIS, OR
ZIP 97330
Phone: (541) 758-3000

The provider's authorized official is Richard Donovan .
The authorized official title is Executive Director and has the following contact phone number (541) 758-3000.

The CLIA number assigned to this NPI record is 38D0965932 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)		OREGON	Yes
2	101YM0800X	Counselor	Mental Health		OREGON	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	228527	OTHER	OREGON	OREGON HEALTH PLAN ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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