=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184421042
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMUNITY COUNSELING SOLUTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2025
-----------------------------------------------------
Last Update Date | 02/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2583 WESTGATE
-----------------------------------------------------
City | PENDLETON
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97801-9613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-276-6330
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 469
-----------------------------------------------------
City | HEPPNER
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97836-0469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-676-9161
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS OPERATIONS MANAGER
-----------------------------------------------------
Name | LINSEY HANNA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 541-676-9161
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 323P00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------