Provider Demographics
NPI:1699362285
Name:ORTC, LLC
Entity Type:Organization
Organization Name:ORTC, LLC
Other - Org Name:TRI CITIES TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACT MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-322-1794
Mailing Address - Street 1:1445 SPAULDING AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4715
Mailing Address - Country:US
Mailing Address - Phone:509-541-1492
Mailing Address - Fax:509-541-1943
Practice Address - Street 1:1445 SPAULDING AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4715
Practice Address - Country:US
Practice Address - Phone:509-541-1492
Practice Address - Fax:509-541-1943
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARO0587848OtherDEA