# PENDLETON ACADMIES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eastern Oregon Children's Multi-Treatment Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417991258
- **Authorized official:** MR. P. TERRY EDVALSON (INTERIM EXECUTIVE DIRECTOR)
- **Authorized official phone:** (541) 966-7810

## Contact information

- **Practice address:** 622 AIRPORT RD, PENDLETON, OR 97801-4598
- **Practice address phone:** (541) 276-0057
- **Practice address fax:** (541) 276-1704
- **Mailing address:** 622 AIRPORT RD, PENDLETON, OR 97801-4598
- **Mailing address phone:** (541) 276-0057
- **Mailing address fax:** (541) 276-1704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | OR | — |
| 103T00000X | Psychologist | — | OR | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | OR | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TC1900X | Counseling Psychologist | — | OR | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 251B00000X | Case Management Agency | — | OR | — |
| 251S00000X | Community/Behavioral Health Agency | — | OR | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | OR | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | OR | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | OR | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | — |
| 385HR2055X | Child Mental Illness Respite Care | — | OR | — |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 11/21/2008