KLAMATH YOUTH DEVELOPMENT CENTER NPI 1396172375

NPI Information

NPI: 1396172375
Provider Name: KLAMATH YOUTH DEVELOPMENT CENTER

Other Name: KLAMATH CHILD AND FAMILY TREATMENT CENTER

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
2210 N ELDORADO AVE
KLAMATH FALLS, OR
ZIP 97601
Phone: (541) 883-1030
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KLAMATH YOUTH DEVELOPMENT CENTER is a community based residential treatment facility mental illness in Klamath Falls, OR. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. KLAMATH YOUTH DEVELOPMENT CENTER NPI is 1396172375. The provider is registered as an organization entity type.
The provider Other Name Is Klamath Child And Family Treatment Center.

The provider's business location address is:

2210 N ELDORADO AVE
KLAMATH FALLS, OR
ZIP 97601-418
Phone: (541) 883-1030

The provider's authorized official is Jenny Ellen Wheeler .
The authorized official title is Transition Cordinator Sbs and has the following contact phone number (541) 591-5604.

The enumeration date for this NPI number is 10/4/2013 and was last updated on 10/4/2013.

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	320800000X	Community Based Residential Treatment Facility, Mental Illness			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	223354	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: 5/5/2024

NPI Synchronization or Removal

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