Healthcare Provider Details

I. General information

NPI: 1225861784
Provider Name (Legal Business Name): OREGON BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 CLUB RD STE 360
EUGENE OR
97401-2463
US

IV. Provider business mailing address

PO BOX 159
WALTERVILLE OR
97489-0159
US

V. Phone/Fax

Practice location:
  • Phone: 541-240-2100
  • Fax:
Mailing address:
  • Phone: 541-240-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. OWEN JAMES STEINBACHER JR.
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 541-240-2100