Provider Demographics
NPI:1548471543
Name:CATHOLIC COMMUNITY SERVICES
Entity type:Organization
Organization Name:CATHOLIC COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HUPP
Authorized Official - Suffix:
Authorized Official - Credentials:CADC II, NCAC II
Authorized Official - Phone:503-390-2600
Mailing Address - Street 1:PO BOX 20400
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97307-0400
Mailing Address - Country:US
Mailing Address - Phone:503-390-2600
Mailing Address - Fax:503-390-8562
Practice Address - Street 1:3737 PORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97303-2511
Practice Address - Country:US
Practice Address - Phone:503-390-2600
Practice Address - Fax:503-390-8562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered251S00000XAgenciesCommunity/Behavioral Health