Provider Demographics
NPI:1598331753
Name:KLAMATH TRIBAL HEALTH AND FAMILY SERVICES
Entity Type:Organization
Organization Name:KLAMATH TRIBAL HEALTH AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER - INTERIM
Authorized Official - Prefix:
Authorized Official - First Name:CHARISE
Authorized Official - Middle Name:RILEY
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-882-1487
Mailing Address - Street 1:3949 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4746
Mailing Address - Country:US
Mailing Address - Phone:541-882-1487
Mailing Address - Fax:541-880-5590
Practice Address - Street 1:635 MAIN ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-6007
Practice Address - Country:US
Practice Address - Phone:541-884-1851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management