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GATHERED & WISE LLC NPI 1669830865


NPI Information

NPI: 1669830865
Provider Name: GATHERED & WISE LLC

Former Legal Business Name: HOLLY POMME MSW LCSW

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
112 E BURNETT ST
STAYTON, OR
ZIP 97383
Phone: (541) 704-7511
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GATHERED & WISE LLC is a community behavioral health in Stayton, OR. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. GATHERED & WISE LLC NPI is 1669830865. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Holly Pomme Msw Lcsw.

The provider's business location address is:

112 E BURNETT ST
STAYTON, OR
ZIP 97383-704
Phone: (541) 704-7511
Fax: (541) 325-4082

The provider's authorized official is Holly Elise Pomme .
The authorized official title is Owner/clinical Director and has the following contact phone number (541) 704-7511.

The enumeration date for this NPI number is 2/2/2016 and was last updated on 12/14/2023.


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
1251S00000XCommunity/Behavioral HealthL6179OREGONYes

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
1500797440MEDICAIDOREGON

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

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