CREEKSIDE
NPI 1811078165
Psychiatric Residential Treatment Facility in The Dalles, OR

NPI Status: Active since October 17, 2006

Contact Information

1021 W 9TH ST
THE DALLES, OR
ZIP 97058
Phone: (541) 298-1920
Fax: (541) 298-1917

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About CREEKSIDE

This page provides the complete NPI Profile along with additional information for Creekside, a provider established in The Dalles, Oregon operating as a Psychiatric Residential Treatment Facility. The healthcare provider is registered in the NPI registry with number 1811078165 assigned on October 2006. The practitioner's primary taxonomy code is 323P00000X with license number 776 (OR). The provider is registered as an organization and their NPI record was last updated 16 years ago. The provider's other name is Creekside. The authorized official of this NPI record is Mr. Robert C Beckett (Executive Director)

NPI
1811078165
Provider Legal Name
COLUMBIACARE SERVICES
Other Organization Name
CREEKSIDE
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
1021 W 9TH ST THE DALLES, OR 97058
Location Phone
(541) 298-1920
Location Fax
(541) 298-1917
Mailing Address
3587 HEATHROW WAY MEDFORD, OR 97504
Mailing Phone
(541) 858-8170
Mailing Fax
(541) 298-1917
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-17-2006
Last Update Date
05-13-2009
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatric Residential Treatment Facility

Taxonomy Code
323P00000X
Type
Residential Treatment Facilities
License No.
776
License State
OR
Taxonomy Description
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1320800000XResidential Treatment Facilities

Community Based Residential Treatment Facility, Mental Illness

776 (OR)
2385H00000XRespite Care Facility

Respite Care

776 (OR)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. ROBERT C BECKETT

Authorized Official Title
EXECUTIVE DIRECTOR
Authorized Official Phone
(541) 858-8170

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
276355MEDICAID (05)OR 
515195OTHER (01)ORMC SERVICE PMT

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1811078165
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
28210716112
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 2 + 1 + 0 + 7 + 1 + 6 + 1 + 1 + 2 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1811078165 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1619335874 WILLIAM BYERS
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1346608502 ISAAC IRBY
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1073971230 HARLEY PARKKI
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1417086513 BRIAN CHAPPELL
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1891153052 JULIA BRENDEN
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1700244969 ERNEST BRENDEN
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1437517695 JESSICA HICKS
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1255799417 SUZANNE JORDAN
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1164880324 KIMBERLY LONG
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1790143956 MICHAEL MAIER
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1609234863 KATHRYNN MCBAIN
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1518325778 ANDREW MILES
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1346609757 KRIS WALDRON
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1922467158 EMMA WILSON
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1609236975 HELLEN WARKENTIN
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1053772228 JENNIFER LOPEZ
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1891234803 STACEY BLAIR
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1255864344 SCOTT LACOCK
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1740717941 RACHEL PRUETT
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920
1598288714 JEANNETTE CHACE
Individual
Counselor (Mental Health)1021 W 9TH ST
THE DALLES, OR 97058
(541) 298-1920

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811078165, enumerated in the NPI registry as an "organization" on October 17, 2006

The provider is located at 1021 W 9th St The Dalles, Or 97058 and the phone number is (541) 298-1920

This medical organization specializes in Psychiatric Residential Treatment Facility with taxonomy code 323P00000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on October 17, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.