Provider Demographics
NPI:1609502350
Name:ORTC, LLC
Entity Type:Organization
Organization Name:ORTC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-617-4544
Mailing Address - Street 1:82 E FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-1070
Mailing Address - Country:US
Mailing Address - Phone:541-617-4544
Mailing Address - Fax:
Practice Address - Street 1:82 E FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1070
Practice Address - Country:US
Practice Address - Phone:541-617-4544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No251B00000XAgenciesCase Management
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
251B00000XOtherTAXONOMY
261QM2800XOtherTAXONOMY CODE
261QR0405XOtherTAXONOMY