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Organization

TRANSPONDER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BEN LILLEY (PROGRAM DIRECTOR)
(541) 321-0872
Entity
Organization

Contact information

Practice address
440 MAXWELL RD, EUGENE, OR 97404
(541) 321-0872
(541) 632-8952
Mailing address
PO BOX 827, EUGENE, OR 97440
(541) 321-0872
(541) 632-8952

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
175T00000X
Peer Specialist
251S00000X
Community/Behavioral Health Agency
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/15/2023
Last updated
05/13/2025
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