Provider Demographics
NPI:1083838148
Name:DESCHUTES COUNTY ADULT JAIL
Entity Type:Organization
Organization Name:DESCHUTES COUNTY ADULT JAIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:JAIL CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-617-3383
Mailing Address - Street 1:63333 HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-8587
Mailing Address - Country:US
Mailing Address - Phone:541-312-6400
Mailing Address - Fax:
Practice Address - Street 1:63333 HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-8587
Practice Address - Country:US
Practice Address - Phone:541-312-6400
Practice Address - Fax:541-318-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR081001496251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)