Provider Demographics
NPI:1790495802
Name:SARVIS MENTAL HEALTH INC
Entity Type:Organization
Organization Name:SARVIS MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CROSS-SARVIS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:503-217-4455
Mailing Address - Street 1:2647 CREEKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6939
Mailing Address - Country:US
Mailing Address - Phone:503-705-8310
Mailing Address - Fax:
Practice Address - Street 1:5 CENTERPOINTE DR STE 400
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8661
Practice Address - Country:US
Practice Address - Phone:503-217-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty