Provider Demographics
NPI:1558897710
Name:VOLUNTEERS OF AMERICA
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEER RECOVERY MENTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RATERRA
Authorized Official - Middle Name:BOWENS
Authorized Official - Last Name:BOWENS
Authorized Official - Suffix:
Authorized Official - Credentials:CRM
Authorized Official - Phone:971-806-0587
Mailing Address - Street 1:10564 SE WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2809
Mailing Address - Country:US
Mailing Address - Phone:971-806-0587
Mailing Address - Fax:503-228-9558
Practice Address - Street 1:10564 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2809
Practice Address - Country:US
Practice Address - Phone:971-806-0587
Practice Address - Fax:503-228-9558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17-CRM-071251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR17-CRM-071OtherACCBO