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Organization
ADAPT
Active
Organization
ADAPT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE PIPER (CEO)
(541) 672-2691
Entity
Organization
Contact information
Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 672-2691
(541) 673-5642
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 672-2691
(541) 673-5642
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
101YM0800X
Mental Health Counselor
—
OR
261Q00000X
Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218156
—
OR
Enumeration date
07/06/2006
Last updated
09/26/2018
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