Healthcare Provider Details

I. General information

NPI: 1356264238
Provider Name (Legal Business Name): CENTER FOR LOVING-AWARENESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 SURREY LN
EUGENE OR
97402-1481
US

IV. Provider business mailing address

4736 ROYAL AVE # 254
EUGENE OR
97402-1755
US

V. Phone/Fax

Practice location:
  • Phone: 707-502-2833
  • Fax: 541-225-5781
Mailing address:
  • Phone: 707-502-2833
  • Fax: 541-225-5781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH SANDIN
Title or Position: OWNER
Credential: LCSW
Phone: 707-502-2833