Provider Demographics
NPI:1841922168
Name:COMPLETE FAMILY CARE
Entity type:Organization
Organization Name:COMPLETE FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIESHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-243-0414
Mailing Address - Street 1:3159 CARPENTERS PARK RD
Mailing Address - Street 2:
Mailing Address - City:DAVIDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15928-9223
Mailing Address - Country:US
Mailing Address - Phone:814-479-5906
Mailing Address - Fax:814-479-5906
Practice Address - Street 1:15548 NW OVERTON DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5371
Practice Address - Country:US
Practice Address - Phone:503-686-3328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR9999999999Medicaid