Healthcare Provider Details

I. General information

NPI: 1073726253
Provider Name (Legal Business Name): RELIANT BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E 10TH AVE STE 330
EUGENE OR
97401-3357
US

IV. Provider business mailing address

401 E 10TH AVE STE 330
EUGENE OR
97401-3357
US

V. Phone/Fax

Practice location:
  • Phone: 800-922-7009
  • Fax: 877-730-5113
Mailing address:
  • Phone: 800-922-7009
  • Fax: 877-730-5113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
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: DR. THOMAS V FOSTER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 503-802-9800