Provider Demographics
NPI:1588956551
Name:EASTERN OREGON HUMAN SERVICES CONSORTIUM
Entity type:Organization
Organization Name:EASTERN OREGON HUMAN SERVICES CONSORTIUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL ASSISTANCE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-490-3263
Mailing Address - Street 1:309 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-2107
Mailing Address - Country:US
Mailing Address - Phone:541-298-2101
Mailing Address - Fax:541-298-7996
Practice Address - Street 1:309 E 2ND ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-2107
Practice Address - Country:US
Practice Address - Phone:541-298-2101
Practice Address - Fax:541-298-7996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health