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Organization
COLUMBIACARE SERVICES
Active
Organization
COLUMBIACARE SERVICES
Active
Other names
Creekside
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR)
(541) 858-8170
Entity
Organization
Contact information
Practice address
1021 W 9TH ST, THE DALLES, OR 97058-1007
(541) 298-1920
(541) 298-1917
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-7499
(541) 858-8170
(541) 858-8167
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
776
OR
323P00000X
Psychiatric Residential Treatment Facility
Primary
776
OR
385H00000X
Respite Care
776
OR
Other
Enumeration date
10/17/2006
Last updated
05/13/2009
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