PENDLETON ACADMIES NPI 1417991258

NPI Information

NPI: 1417991258
Provider Name: PENDLETON ACADMIES

Former Legal Business Name: EASTERN OREGON CHILDREN'S MULTI-TREATMENT CENTER

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
622 AIRPORT RD
PENDLETON, OR
ZIP 97801
Phone: (541) 276-0057
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PENDLETON ACADMIES is a residential treatment facility emotionally disturbed children in Pendleton, OR. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. PENDLETON ACADMIES NPI is 1417991258. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Eastern Oregon Children's Multi-treatment Center.

The provider's business location address is:

622 AIRPORT RD
PENDLETON, OR
ZIP 97801-598
Phone: (541) 276-0057
Fax: (541) 276-1704

The provider's authorized official is P. Terry Edvalson .
The authorized official title is Interim Executive Director and has the following contact phone number (541) 966-7810.

The enumeration date for this NPI number is 6/15/2006 and was last updated on 11/21/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	385HR2055X	Respite Care	Respite Care, Mental Illness, Child	OREGON	No
2	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		OREGON	No
3	320800000X	Community Based Residential Treatment Facility, Mental Illness		OREGON	No
4	251S00000X	Community/Behavioral Health		OREGON	No
5	251B00000X	Case Management		OREGON	No
6	101YM0800X	Counselor	Mental Health	OREGON	No
7	103T00000X	Psychologist		OREGON	No
8	103TB0200X	Psychologist	Cognitive & Behavioral	OREGON	No
9	323P00000X	Psychiatric Residential Treatment Facility			No
10	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities			No
11	103TC0700X	Psychologist	Clinical		No
12	103TC1900X	Psychologist	Counseling	OREGON	No
13	103TC2200X	Psychologist	Clinical Child & Adolescent		No
14	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	312040	MEDICAID	OREGON
2	312041	MEDICAID	OREGON
3	313205	MEDICAID	OREGON
4	313437	MEDICAID	OREGON
5	182229	MEDICAID	OREGON
6	312056	MEDICAID	OREGON
7	312048	MEDICAID	OREGON
8	PCG023	MEDICAID	OREGON
9	S20475	MEDICAID	OREGON
10	312064	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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