Organization
SISKIYOU COMMUNITY HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC VAN HOUTEN MSW, MBA (CHIEF EXECUTIVE OFFICER)
(541) 472-4777
Entity
Organization
Contact information
Practice address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1051
(541) 472-4777
(541) 471-1439
Mailing address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1051
(541) 472-4777
(541) 471-1439
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
127725
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127725
—
OR
Enumeration date
10/10/2005
Last updated
07/02/2025
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