Healthcare Provider Details

I. General information

NPI: 1841518974
Provider Name (Legal Business Name): PLAZA DE NUESTRA COMUNIDAD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 CENTENNIAL BLVD
SPRINGFIELD OR
97477-3363
US

IV. Provider business mailing address

195 W 12TH AVE
EUGENE OR
97401-3408
US

V. Phone/Fax

Practice location:
  • Phone: 541-687-2667
  • Fax:
Mailing address:
  • Phone: 541-687-2667
  • Fax: 541-284-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID SAEZ
Title or Position: CO-EXECUTIVE DIRECTOR
Credential:
Phone: 541-687-2667