Healthcare Provider Details

I. General information

NPI: 1275907339
Provider Name (Legal Business Name): UNITED COMMUNITY ACTION NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2015
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 W MADRONE ST
ROSEBURG OR
97470-3090
US

IV. Provider business mailing address

280 NE KENNETH FORD DR
ROSEBURG OR
97470-1034
US

V. Phone/Fax

Practice location:
  • Phone: 541-440-3539
  • Fax:
Mailing address:
  • Phone: 541-440-3622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: ELISE HANSEN
Title or Position: PUBLIC HEALTH NURSE COORDINATOR
Credential:
Phone: 541-440-3614