Healthcare Provider Details

I. General information

NPI: 1215828041
Provider Name (Legal Business Name): ORI COMMUNITY AND EVALUATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 SPORTS WAY
SPRINGFIELD OR
97477-2019
US

IV. Provider business mailing address

3800 SPORTS WAY
SPRINGFIELD OR
97477-2019
US

V. Phone/Fax

Practice location:
  • Phone: 541-484-2123
  • Fax:
Mailing address:
  • Phone: 541-484-2123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL HOLMES X
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 541-484-2123