JENNINGS LODGE – NPI #1508126368
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

JENNINGS LODGE is a community based residential treatment facility located in MEDFORD, OR. NPPES has assigned the NPI number 1508126368 to JENNINGS LODGE on May 25, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “JENNINGS LODGE” is a dba name, the actual legal business name for this organization is COLUMBIACARE SERVICES. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JENNINGS LODGE below.

NPI Profile for
COLUMBIACARE SERVICES

NPI Number
1508126368
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COLUMBIACARE SERVICES
Doing Business As (dba): JENNINGS LODGE
Primary location
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone: (541) 858-8170 Fax:
Mailing address
4545 SE INA AVE
MILWAUKIE, OR 97267-5916
Phone: (541) 858-8170 Fax:
Organization Subpart
No
Authorized Official
ROBERT BECKETT
EXECUTIVE DIRECTOR
Phone: (541) 858-8170
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.