Provider Demographics
NPI:1477250603
Name:ADAPT
Entity Type:Organization
Organization Name:ADAPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-492-0134
Mailing Address - Street 1:PO BOX 1121
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-0254
Mailing Address - Country:US
Mailing Address - Phone:541-672-2691
Mailing Address - Fax:541-492-0190
Practice Address - Street 1:356 NE BEACON DR
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-3815
Practice Address - Country:US
Practice Address - Phone:541-474-1033
Practice Address - Fax:541-474-0770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADAPT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health