Healthcare Provider Details
I. General information
NPI: 1104329523
Provider Name (Legal Business Name): CORVALLIS NEIGHBORHOOD HOUSING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2018
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
212 MAIN STREET
SPRINGFILED OR
97477
US
IV. Provider business mailing address
212 MAIN STREET
SPRINGFILED OR
97477
US
V. Phone/Fax
- Phone: 541-345-7106
- Fax: 541-345-9584
- Phone: 541-345-7106
- Fax: 541-345-9584
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAYSON
MATTHEWS
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 541-345-7106