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General NPI Number Information
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NPI Number | 1629270780
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Entity Type | Organization
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Legal Business Name | HOMESTEAD YOUTH & FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 816 SE 15TH ST.
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City | PENDLETON
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State | OR
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Zip | 97801
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Country | US
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Telephone | 541-276-5433
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Fax | 541-276-8605
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Provider Business Mailing Address
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Address Line | PO BOX 1325
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City | PENDLETON
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State | OR
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Zip | 97801-0260
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Country | US
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Telephone | 541-276-5433
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Fax | 541-276-8605
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Authorized Official
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Title or Position | CLERICAL SPECIALIST
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Name | CANDICE D. CREGER
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Credential |
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Telephone | 541-276-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number | 12718785
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License Number State | OR
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