Provider Demographics
NPI:1902969116
Name:LUTHERAN COMMUNITY SERVICE
Entity Type:Organization
Organization Name:LUTHERAN COMMUNITY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ROBBINS
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:541-480-6626
Mailing Address - Street 1:203 NE COURT ST
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1935
Mailing Address - Country:US
Mailing Address - Phone:541-447-7441
Mailing Address - Fax:541-447-2066
Practice Address - Street 1:203 NE COURT ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1935
Practice Address - Country:US
Practice Address - Phone:541-447-7441
Practice Address - Fax:541-447-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health