COW CREEK HEALTH & WELLNESS CTR NPI 1205104718

NPI Information

NPI: 1205104718
Provider Name: COW CREEK HEALTH & WELLNESS CTR

Former Legal Business Name: COW CREEK BAND OF UMPQUA TRIBE OF INDIANS

Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
2371 NE STEPHENS ST STE 200
ROSEBURG, OR
ZIP 97470
Phone: (541) 672-8533
Get Directions

COW CREEK HEALTH & WELLNESS CTR is an addiction (substance use disorder) counselor in Roseburg, OR. COW CREEK HEALTH & WELLNESS CTR NPI is 1205104718. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Cow Creek Band Of Umpqua Tribe Of Indians.

The provider's business location address is:

2371 NE STEPHENS ST STE 200
ROSEBURG, OR
ZIP 97470-399
Phone: (541) 672-8533
Fax: (541) 672-4993

The provider's authorized official is Michael J Rondeau .
The authorized official title is Ceo and has the following contact phone number (541) 672-9405.

The enumeration date for this NPI number is 12/12/2011 and was last updated on 12/12/2011.

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)	10-09-68U	OREGON	Yes

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	165772	MEDICAID	OREGON

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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