Provider Demographics
NPI:1144329863
Name:GRANT COUNTY CENTER FOR HUMAN DEVELOPMENT
Entity type:Organization
Organization Name:GRANT COUNTY CENTER FOR HUMAN DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRADEY
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:BS QMHP
Authorized Official - Phone:541-575-1466
Mailing Address - Street 1:528 EAST MAIN ST
Mailing Address - Street 2:SUITE W
Mailing Address - City:JOHN DAY
Mailing Address - State:OR
Mailing Address - Zip Code:97845
Mailing Address - Country:US
Mailing Address - Phone:541-575-1466
Mailing Address - Fax:541-575-1411
Practice Address - Street 1:528 EAST MAIN ST
Practice Address - Street 2:SUITE W
Practice Address - City:JOHN DAY
Practice Address - State:OR
Practice Address - Zip Code:97845
Practice Address - Country:US
Practice Address - Phone:541-575-1466
Practice Address - Fax:541-575-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YA0400X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR276357OtherMEDICAID CHEMICAL DEPENDE
OR276356Medicaid