Provider Demographics
NPI:1003672726
Name:NORTHEAST OREGON COMPASSION CENTER
Entity Type:Organization
Organization Name:NORTHEAST OREGON COMPASSION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:CADC II
Authorized Official - Phone:541-523-9845
Mailing Address - Street 1:1250 HUGHES LN
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-9600
Mailing Address - Country:US
Mailing Address - Phone:541-523-9845
Mailing Address - Fax:
Practice Address - Street 1:1250 HUGHES LN
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-9600
Practice Address - Country:US
Practice Address - Phone:541-523-9845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable