# COLUMBIACARE SERVICES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Driftwood Lodge
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609963842
- **Authorized official:** MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (541) 858-8170

## Contact information

- **Practice address:** 29413 RUSSELL ST, GOLD BEACH, OR 97444-7748
- **Practice address phone:** (541) 247-6566
- **Practice address fax:** (541) 247-6549
- **Mailing address:** 3587 HEATHROW WAY, MEDFORD, OR 97504
- **Mailing address phone:** (541) 858-8170
- **Mailing address fax:** (541) 858-8167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | 717 | OR | — |
| 323P00000X | Psychiatric Residential Treatment Facility | 717 | OR | Yes |

## Other

- **Enumeration date:** 10/09/2006
- **Last updated:** 05/19/2009