Provider Demographics
NPI:1821238304
Name:DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Entity Type:Organization
Organization Name:DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:THERSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELISOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-966-2915
Mailing Address - Street 1:73239 CONFEDERATED WAY
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-9099
Mailing Address - Country:US
Mailing Address - Phone:541-966-2915
Mailing Address - Fax:
Practice Address - Street 1:73239 CONFEDERATED WAY
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-9099
Practice Address - Country:US
Practice Address - Phone:541-966-2915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONFEDERATED TRIBES OF THE UMATILLA INDIAN RESERVATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR276305Medicaid