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General NPI Number Information
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NPI Number | 1437213865
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Entity Type | Organization
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Legal Business Name | CODA, INC.
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1027 E BURNSIDE ST
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City | PORTLAND
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State | OR
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Zip | 97214-1328
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Country | US
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Telephone | 503-239-8400
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Fax | 503-239-8407
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Provider Business Mailing Address
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Address Line | 1027 E BURNSIDE ST
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City | PORTLAND
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State | OR
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Zip | 97214-1328
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Country | US
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Telephone | 503-239-8400
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Fax | 503-239-8407
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. TIMOTHY T. HARTNETT
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Credential |
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Telephone | 503-239-8400
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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 | NONE ASSIGNED
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License Number State | OR
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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 | NONE ASSIGNED
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | NONE ASSIGNED
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | NONE ASSIGNED
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | NONE ASSIGNED
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License Number State | OR
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Taxonomy #7
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number | NONE ASSIGNED
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License Number State | OR
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Taxonomy #8
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | NONE ASSIGNED
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License Number State | OR
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Taxonomy #9
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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 | NONE ASSIGNED
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License Number State | OR
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Taxonomy #10
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | NONE ASSIGNED
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License Number State | OR
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