Healthcare Provider Details

I. General information

NPI: 1194814103
Provider Name (Legal Business Name): COUNTY OF LINN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 4TH AVE SW
ALBANY OR
97321-2804
US

IV. Provider business mailing address

PO BOX 100
ALBANY OR
97321-0031
US

V. Phone/Fax

Practice location:
  • Phone: 541-967-3819
  • Fax: 541-967-7259
Mailing address:
  • Phone: 541-967-3819
  • Fax: 541-967-7259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOR

VIII. Authorized Official

Name: TODD NOBLE
Title or Position: HEALTH ADMINISTRATOR
Credential: LPC
Phone: 541-924-6916