Organization
PENDLETON ACADMIES
Active
Other names
Eastern Oregon Children's Multi-Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. P. TERRY EDVALSON (INTERIM EXECUTIVE DIRECTOR)
(541) 966-7810
Entity
Organization
Contact information
Practice address
622 AIRPORT RD, PENDLETON, OR 97801-4598
(541) 276-0057
(541) 276-1704
Mailing address
622 AIRPORT RD, PENDLETON, OR 97801-4598
(541) 276-0057
(541) 276-1704
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OR
103T00000X
Psychologist
—
OR
103TB0200X
Cognitive & Behavioral Psychologist
—
OR
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
OR
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
251B00000X
Case Management Agency
—
OR
251S00000X
Community/Behavioral Health Agency
—
OR
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
OR
320800000X
Mental Illness Community Based Residential Treatment Facility
—
OR
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
OR
323P00000X
Psychiatric Residential Treatment Facility
—
—
385HR2055X
Child Mental Illness Respite Care
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182229
—
OR
05
—
312040
—
OR
05
—
312041
—
OR
05
—
312048
—
OR
05
—
312056
—
OR
05
—
312064
—
OR
05
—
313205
—
OR
05
—
313437
—
OR
05
—
PCG023
—
OR
05
—
S20475
—
OR
Enumeration date
06/15/2006
Last updated
11/21/2008
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