Healthcare Provider Details

I. General information

NPI: 1659885606
Provider Name (Legal Business Name): SPONSORS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 04/20/2020
Certification Date: 04/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 HIGHWAY 99 N
EUGENE OR
97402-2404
US

IV. Provider business mailing address

338 HIGHWAY 99 N
EUGENE OR
97402-2404
US

V. Phone/Fax

Practice location:
  • Phone: 541-485-8341
  • Fax: 541-683-6196
Mailing address:
  • Phone: 541-485-8341
  • Fax: 541-683-6196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
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: MR. NICHOLAS MATHIAS THOMAS CRAPSER
Title or Position: DEPUTY DIRECTOR
Credential: MA
Phone: 541-505-5659