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Organization

DESCHUTES COUNTY OREGON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID GERARD INBODY (HEALTH SERVICES DEPUTY DIRECTOR)
(541) 322-7678
Entity
Organization

Contact information

Practice address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
(541) 322-7565
Mailing address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
(541) 322-7565

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
047621
OR
05
145789
OR
05
170912
OR
05
184176
OR
05
500500013
OR
05
500602527
OR
Enumeration date
06/14/2006
Last updated
10/13/2017
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