Healthcare Provider Details

I. General information

NPI: 1881326577
Provider Name (Legal Business Name): RESTORED CONNECTIONS PEER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 E 12TH AVE
EUGENE OR
97401-3513
US

IV. Provider business mailing address

3162 30TH COURT SE
ALBANY OR
97322
US

V. Phone/Fax

Practice location:
  • Phone: 541-636-3506
  • Fax:
Mailing address:
  • Phone: 503-857-8494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: STEPHANIE MARIE CAMERON
Title or Position: EXECUTIVE DIRECTOR
Credential: CRM, CADC I
Phone: 503-857-8494