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1750373346

NPI Code Detail

MEDICARE: ADAPT

MEDICARE: ADAPT

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor		OR
2	101YM0800X	Mental Health Counselor		OR
3	324500000X	Substance Abuse Rehabilitation Facility		OR
4	3245S0500X	Children's Substance Abuse Rehabilitation Facility		OR
5	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	024030000	OTHER	OR	REGENCE - OUTPATIENT
3	100394400	OTHER	OR	REGENCE - RESIDENTIAL

General Provider Information

NPI Number	:	1750373346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAPT

Provider Business Mailing Address
First Line	:	PO BOX 1121
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97470-0254
Country	:	US
Telephone Number	:	541-672-2691
Fax Number	:	541-673-5642

Provider Business Practice Location Address
First Line	:	548 SE JACKSON ST
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97470-4983
Country	:	US
Telephone Number	:	541-672-2691
Fax Number	:	541-673-5642

Authorized Official
Title or Position	:	CEO
Name	:	BRUCE PIPER
Credential	:
Telephone Number	:	541-672-2691

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	05/08/2019

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1861694994 — MS. SARA ANN BAXTER LCSW
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1659504819 — KARLA WHITLOCK MA, LPC
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1023375359 — STEVEN COLLINS MA, LPC
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Directions to “ADAPT ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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