Provider Demographics
NPI:1669000865
Name:MID-VALLEY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MID-VALLEY HEALTHCARE, INC.
Other - Org Name:SAMARITAN TREATMENT & RECOVERY SERVICES (RESIDENTIAL)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:541-602-4907
Mailing Address - Street 1:PO BOX 1193
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-1193
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2869
Practice Address - Country:US
Practice Address - Phone:541-451-6388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MID VALLEY HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-01
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility