Provider Demographics
NPI:1770562670
Name:COUNTY OF HARNEY
Entity type:Organization
Organization Name:COUNTY OF HARNEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:541-573-8360
Mailing Address - Street 1:415 N FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:OR
Mailing Address - Zip Code:97720-1417
Mailing Address - Country:US
Mailing Address - Phone:541-573-8360
Mailing Address - Fax:541-573-8389
Practice Address - Street 1:415 N FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:OR
Practice Address - Zip Code:97720-1417
Practice Address - Country:US
Practice Address - Phone:541-573-8360
Practice Address - Fax:541-573-8389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16-1023251G00000X
OR131301251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
50074OtherCOIHS
387000Medicare ID - Type Unspecified
50074OtherCOIHS