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Organization
CATHOLIC COMMUNITY SERVICES OF THE MID-WILLAMETTE VALLEY AND CENTRAL
Active
Organization
CATHOLIC COMMUNITY SERVICES OF THE MID-WILLAMETTE VALLEY AND CENTRAL
Active
Parent organization
CATHOLIC COMMUNITY SERVICES OF THE MID-WILLAMETTE VALLEY AND CENTRAL
Other names
Catholic Community Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CATHOLIC COMMUNITY SERVICES OF THE MID-WILLAMETTE VALLEY AND CENTRAL
Authorized official
MS. MARGARET A MANFROI (BILLING SPECIALIST)
(503) 856-7006
Entity
Organization
Contact information
Practice address
3737 PORTLAND RD, SALEM, OR 97301
(503) 390-2600
(503) 390-8629
Mailing address
3737 PORTLAND RD, SALEM, OR 97301
(503) 390-2600
(503) 390-8629
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030585
CCC OMAP PROVIDER NUMBER
OR
01
—
182536
NS PROVIDER NUMBER
OR
01
—
182536
NEW STEP
—
01
—
226320
ISN PROVIDER NUMBER
OR
01
—
230442
CCC PROVIDER NUMBER
OR
01
—
230442
COUNSEL
—
01
—
261545
RAINBOW PROVIDER NUMBER
OR
01
—
931280935
ISN TAX ID
OR
Enumeration date
03/21/2007
Last updated
02/25/2015
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