WALLOWA VALLEY CENTER FOR WELLNESS NPI 1417192972

NPI Information

  • NPI: 1417192972
  • Provider Name: WALLOWA VALLEY CENTER FOR WELLNESS
  • Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
  • Entity Type: Organization
  • Other Name: WALLOWA RIVER HOUSE
  • CLIA Number: 38D2118594
  • Address: 601 WHISKEY CREEK RD
    WALLOWA, OR
    ZIP 97885
  • Phone: (541) 886-3142

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NPI Details

WALLOWA VALLEY CENTER FOR WELLNESS is a community based residential treatment facility mental illness in Wallowa, OR. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. WALLOWA VALLEY CENTER FOR WELLNESS NPI is 1417192972. The provider is registered as an organization entity type.
The provider Other Name Is Wallowa River House.

The provider's business location address is:

601 WHISKEY CREEK RD
WALLOWA, OR
ZIP 97885-129
Phone: (541) 886-3142

The provider's authorized official is Chantay Jett .
The authorized official title is Executive Director and has the following contact phone number (541) 426-4524.

The CLIA number assigned to this NPI record is 38D2118594 - other - residential trtmnt with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2008 and was last updated on 11/3/2024.

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
1320800000XCommunity Based Residential Treatment Facility, Mental Illness984OREGONYes

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
1517796MEDICAIDOREGON

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: 11/21/2025

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