Provider Demographics
NPI:1730502022
Name:CENTER FOR HUMAN DEVELOPMENT, INC
Entity Type:Organization
Organization Name:CENTER FOR HUMAN DEVELOPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:H. R.
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CEDERHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-962-8800
Mailing Address - Street 1:2301 COVE AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-3906
Mailing Address - Country:US
Mailing Address - Phone:541-962-8800
Mailing Address - Fax:541-963-5272
Practice Address - Street 1:2301 COVE AVE
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-3906
Practice Address - Country:US
Practice Address - Phone:541-962-8800
Practice Address - Fax:541-963-5272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200841579RN251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare