Provider Demographics
NPI:1669893673
Name:THE POWER HOUSE RESIDENTIAL DRUG TREATMENT CENTER INC
Entity type:Organization
Organization Name:THE POWER HOUSE RESIDENTIAL DRUG TREATMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:RAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-314-2781
Mailing Address - Street 1:32405 DIAGONAL RD
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-7503
Mailing Address - Country:US
Mailing Address - Phone:541-314-2781
Mailing Address - Fax:541-567-7672
Practice Address - Street 1:32405 DIAGONAL RD
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-7503
Practice Address - Country:US
Practice Address - Phone:541-314-2781
Practice Address - Fax:541-567-7672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR700094324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility