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General NPI Number Information
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NPI Number | 1518405091
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Entity Type | Organization
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Legal Business Name | THE CITY OF NEWPORT 60 PLUS ACTIVITY CENTER
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 20 SE 2ND ST
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City | NEWPORT
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State | OR
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Zip | 97365
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Country | US
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Telephone | 541-574-0459
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Fax |
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Provider Business Mailing Address
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Address Line | 20 SE 2ND ST
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City | NEWPORT
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State | OR
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Zip | 97365
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Country | US
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Telephone | 541-574-5459
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Fax |
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Authorized Official
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Title or Position | PARKS & REC DIRECTOR
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Name | MR. JAMES A PROTIVA
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Credential | CPRC
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Telephone | 541-265-4855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State | OR
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