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G STREET INTEGRATED HEALTH NPI 1609483049


NPI Information

NPI: 1609483049
Provider Name: G STREET INTEGRATED HEALTH
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

CLIA Number: 38D2170379

Address:
1435 G ST
SPRINGFIELD, OR
ZIP 97477
Phone: (541) 735-9420
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G STREET INTEGRATED HEALTH is an adult mental health clinic center in Springfield, OR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. G STREET INTEGRATED HEALTH NPI is 1609483049. The provider is registered as an organization entity type.

The provider's business location address is:

1435 G ST
SPRINGFIELD, OR
ZIP 97477-113
Phone: (541) 735-9420
Fax: (541) 747-9870

The provider's authorized official is Jennifer Ocker .
The authorized official title is Executive Director and has the following contact phone number (541) 735-9421.

The CLIA number assigned to this NPI record is 38D2170379 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/29/2020 and was last updated on 9/29/2020.


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 Number License State Primary
1261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
2261QM0850XClinic/CenterAdult Mental HealthYes

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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