Provider Demographics
NPI:1073726253
Name:RELIANT BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:RELIANT BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:V
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-802-9800
Mailing Address - Street 1:401 E 10TH AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3357
Mailing Address - Country:US
Mailing Address - Phone:800-922-7009
Mailing Address - Fax:877-730-5113
Practice Address - Street 1:401 E 10TH AVE STE 330
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3357
Practice Address - Country:US
Practice Address - Phone:800-922-7009
Practice Address - Fax:877-730-5113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR=========OtherTAX ID