Provider Demographics
NPI:1417982000
Name:CENTER FOR HUMAN DEVELOPMENT, INC
Entity Type:Organization
Organization Name:CENTER FOR HUMAN DEVELOPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED DESIGNEE
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-962-8812
Mailing Address - Street 1:2301 COVE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850
Mailing Address - Country:US
Mailing Address - Phone:541-962-8800
Mailing Address - Fax:541-963-5272
Practice Address - Street 1:2301 COVE AVENUE
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850
Practice Address - Country:US
Practice Address - Phone:541-962-8800
Practice Address - Fax:541-963-5272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health