1255406237 NPI number — HEART STEPS COUNSELING SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255406237 NPI number — HEART STEPS COUNSELING SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEART STEPS COUNSELING SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255406237
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 FIR STREET
Provider Second Line Business Mailing Address:
SUITE 321
Provider Business Mailing Address City Name:
LA GRANDE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97850-2663
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-963-4005
Provider Business Mailing Address Fax Number:
541-663-8144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 FIR STREET
Provider Second Line Business Practice Location Address:
SUITE 321
Provider Business Practice Location Address City Name:
LA GRANDE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97850-2663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-963-4005
Provider Business Practice Location Address Fax Number:
541-663-8144
Provider Enumeration Date:
11/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MUSGROVE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
NOLE
Authorized Official Title or Position:
PRESIDENT DIRECTOR
Authorized Official Telephone Number:
541-963-4005

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YA0400X , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 213617 . This is a "STATE INSURANCE" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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