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NPI Code Detail

MEDICARE: MID-COLUMBIA CENTER FOR LIVING

MEDICARE: MID-COLUMBIA CENTER FOR LIVING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyOR

General Provider Information

NPI Number : 1366863607
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID-COLUMBIA CENTER FOR LIVING
Provider Business Mailing Address
First Line : 419 E 7TH ST
Second Line : ANNEX A
City : THE DALLES
State : OR
Zip : 97058-2676
Country : US
Telephone Number : 541-296-5452
Fax Number : 541-296-9418
Provider Business Practice Location Address
First Line : 3601 W 10TH ST
Second Line :
City : THE DALLES
State : OR
Zip : 97058-4377
Country : US
Telephone Number : 541-296-5452
Fax Number : 541-296-9418
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : BARBARA SEATTER
Credential :
Telephone Number : 541-296-5452
Provider Enumeration Date : 01/03/2014
Last Update Date : 01/03/2014

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1396113957 — JEFFREY CARRELL
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Directions to “MID-COLUMBIA CENTER FOR LIVING ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.