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NPI Code Detail

MEDICARE: LUTHERAN COMMUNITY SERVICES NORTHWEST

MEDICARE: LUTHERAN COMMUNITY SERVICES NORTHWEST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3026825000OTHERORBLUE CROSS

General Provider Information

NPI Number : 1114058898
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUTHERAN COMMUNITY SERVICES NORTHWEST
Provider Business Mailing Address
First Line : 2545 N ELDORADO AVE
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-6423
Country : US
Telephone Number : 541-883-3471
Fax Number : 541-883-3524
Provider Business Practice Location Address
First Line : 2545 N ELDORADO AVE
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-6423
Country : US
Telephone Number : 541-883-3471
Fax Number : 541-883-3524
Authorized Official
Title or Position : DIRECTOR
Name : NORA FOSTER
Credential :
Telephone Number : 541-883-3471
Provider Enumeration Date : 03/07/2007
Last Update Date : 04/26/2022

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Directions to “LUTHERAN COMMUNITY SERVICES NORTHWEST ” Practice Location

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