# COLUMBACARE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Summit Residential South
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679073712
- **Authorized official:** MICHAEL SEWITSKY (FINANCE DIRECTOR)
- **Authorized official phone:** (541) 858-8170

## Contact information

- **Practice address:** 622 57TH ST, SPRINGFIELD, OR 97478-6821
- **Practice address phone:** (541) 858-8170
- **Mailing address:** 3587 HEATHROW WAY, MEDFORD, OR 97504-4004
- **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 | — | NULL | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/15/2018
- **Last updated:** 02/15/2018