Provider Demographics
NPI:1497180962
Name:CLAY & LORRI THOMAS
Entity Type:Organization
Organization Name:CLAY & LORRI THOMAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOSTER PARENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:5418782975
Authorized Official - Phone:541-878-2975
Mailing Address - Street 1:27105 HIGHWAY 62
Mailing Address - Street 2:
Mailing Address - City:TRAIL
Mailing Address - State:OR
Mailing Address - Zip Code:97541-9771
Mailing Address - Country:US
Mailing Address - Phone:541-878-2975
Mailing Address - Fax:
Practice Address - Street 1:27105 HIGHWAY 62
Practice Address - Street 2:
Practice Address - City:TRAIL
Practice Address - State:OR
Practice Address - Zip Code:97541-9771
Practice Address - Country:US
Practice Address - Phone:541-878-2975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child