Provider Demographics
NPI:1609321207
Name:GREATER OREGON BEHAVIORAL HEALTH INC
Entity type:Organization
Organization Name:GREATER OREGON BEHAVIORAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:OAKS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:541-298-2101
Mailing Address - Street 1:401 E 3RD ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-2562
Mailing Address - Country:US
Mailing Address - Phone:541-298-2012
Mailing Address - Fax:541-298-7996
Practice Address - Street 1:401 E 3RD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-2562
Practice Address - Country:US
Practice Address - Phone:541-298-2012
Practice Address - Fax:541-298-7996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR171M00000X302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization