Provider Demographics
NPI:1376355982
Name:OREGON YOUTH AUTHORITY
Entity type:Organization
Organization Name:OREGON YOUTH AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:O'LEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-701-1047
Mailing Address - Street 1:530 CENTER ST NE STE 500
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3777
Mailing Address - Country:US
Mailing Address - Phone:503-569-2636
Mailing Address - Fax:
Practice Address - Street 1:2001 FRONT ST NE STE 110
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0791
Practice Address - Country:US
Practice Address - Phone:503-378-6804
Practice Address - Fax:503-378-5882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management