Basic Information
| Provider Information | |||||||||
| NPI: | 1265886741 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREATER OREGON BEHAVIORAL HEALTH INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 E 3RD ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | THE DALLES | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970582562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412982101 | ||||||||
| FaxNumber: | 5412987996 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 E 3RD ST STE 101 | ||||||||
| Address2: | |||||||||
| City: | THE DALLES | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970582563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412982101 | ||||||||
| FaxNumber: | 5412987996 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2016 | ||||||||
| LastUpdateDate: | 05/18/2022 | ||||||||
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| AuthorizedOfficialLastName: | WHEELER | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5412982101 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.