Healthcare Provider Details

I. General information

NPI: 1770562670
Provider Name (Legal Business Name): COUNTY OF HARNEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 05/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N FAIRVIEW AVE
BURNS OR
97720-1417
US

IV. Provider business mailing address

415 N FAIRVIEW AVE
BURNS OR
97720-1417
US

V. Phone/Fax

Practice location:
  • Phone: 541-573-8360
  • Fax: 541-573-8389
Mailing address:
  • Phone: 541-573-8360
  • Fax: 541-573-8389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number131301
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number16-1023
License Number StateOR

VIII. Authorized Official

Name: MRS. JODI MCLEAN
Title or Position: DIRECTOR
Credential: RN
Phone: 541-573-8360