Provider Demographics
NPI:1346752565
Name:GREATER OREGON BEHAVIORAL HEALTH INC
Entity Type:Organization
Organization Name:GREATER OREGON BEHAVIORAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEMT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-397-0548
Mailing Address - Street 1:401 E 3RD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-2563
Mailing Address - Country:US
Mailing Address - Phone:541-298-2101
Mailing Address - Fax:
Practice Address - Street 1:401 E 3RD ST STE 101
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-2563
Practice Address - Country:US
Practice Address - Phone:541-298-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker