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ADOLESCENT DAY TREATMENT CENTER INC OF DOUGLAS COUNTY NPI 1629168166


NPI Information

NPI: 1629168166
Provider Name: ADOLESCENT DAY TREATMENT CENTER INC OF DOUGLAS COUNTY

Doing Business As: RIVERSIDE CENTER

Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
671 S.W. MAIN
WINSTON, OR
ZIP 97496
Phone: (541) 679-6129
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ADOLESCENT DAY TREATMENT CENTER INC OF DOUGLAS COUNTY is an adolescent and children mental health clinic center in Winston, OR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. ADOLESCENT DAY TREATMENT CENTER INC OF DOUGLAS COUNTY NPI is 1629168166. The provider is registered as an organization entity type.
The provider Is Doing Business As Riverside Center.

The provider's business location address is:

671 S.W. MAIN
WINSTON, OR
ZIP 97496
Phone: (541) 679-6129

The provider's authorized official is Bonna M Meyer .
The authorized official title is Interim Director and has the following contact phone number (541) 679-6129.

The enumeration date for this NPI number is 10/13/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0855XClinic/CenterAdolescent and Children Mental HealthCERTIFICATE APPROVALOREGONYes
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)CERTIFCATE OF APPROVOREGONX

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1297927MEDICAIDOREGON
2297928MEDICAIDOREGON

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: 11/14/2023

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