Healthcare Provider Details

I. General information

NPI: 1639231715
Provider Name (Legal Business Name): LAUREL HILL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 CENTENNIAL PLZ
EUGENE OR
97401-2421
US

IV. Provider business mailing address

2145 CENTENNIAL PLZ
EUGENE OR
97401-2421
US

V. Phone/Fax

Practice location:
  • Phone: 541-485-6340
  • Fax: 541-984-3124
Mailing address:
  • Phone: 541-485-6340
  • Fax: 541-984-3124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

# 1
Identifier115337
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name: MRS. SHAWN D. MURPHY
Title or Position: EXECUTIVE DIRECTOR
Credential: M.A., CPRP
Phone: 541-485-6340