Organization
CONFEDERATED TRIBES OF COOS, LOWER UMPQUA & SIUSLAW INDIANS
Active
Other names
Three Rivers Health Center - Florence
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RANDOLPH REEVES III MHA (HEALTH ADMINISTRATOR)
(808) 214-7269
Entity
Organization
Contact information
Practice address
3757 HIGHWAY 101, FLORENCE, OR 97439-8993
(541) 997-6685
Mailing address
PO BOX 2000, FLORENCE, OR 97439-0076
(541) 997-6685
(541) 997-1715
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
124Q00000X
Dental Hygienist
—
—
125J00000X
Dental Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165383
—
OR
Enumeration date
06/05/2024
Last updated
06/05/2024
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