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General NPI Number Information
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NPI Number | 1144345570
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Entity Type | Organization
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Legal Business Name | CATHOLIC COMMUNITY SERVICES OF THE MID-WILLAMETTE VALLEY AND CENTRAL
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 02/25/2015
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Provider Practice Location Address
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Address Line | 3737 PORTLAND RD
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City | SALEM
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State | OR
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Zip | 97301
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Country | US
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Telephone | 503-390-2600
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Fax | 503-390-8629
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Provider Business Mailing Address
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Address Line | 3737 PORTLAND RD
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City | SALEM
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State | OR
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Zip | 97301
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Country | US
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Telephone | 503-390-2600
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Fax | 503-390-8629
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | MS. MARGARET A MANFROI
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Credential |
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Telephone | 503-856-7006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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