Healthcare Provider Details

I. General information

NPI: 1669294286
Provider Name (Legal Business Name): UNITED COMMUNITY ACTION NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 NE GARDEN VALLEY BLVD STE 205
ROSEBURG OR
97470-1495
US

IV. Provider business mailing address

251 NE GARDEN VALLEY BLVD STE 205
ROSEBURG OR
97470-1495
US

V. Phone/Fax

Practice location:
  • Phone: 800-301-8226
  • Fax:
Mailing address:
  • Phone: 800-301-8226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: JORDAN JUNGWIRTH
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 541-492-3531