Jeanette Marie Fanning in Portland - Community Based Residential Treatment Facility, Mental Illness
Jeanette Marie Fanning - NPI 1912045139
Jeanette Marie Fanning is a Community Based Residential Treatment Facility, Mental Illness in Portland, Oregon. Jeanette Marie Fanning practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Jeanette Marie Fanning is 1912045139. The last update date is 2007-07-08.
Jeanette Marie Fanning's current location address is 9515 Se 74th Ave, Portland, Oregon. You can contact this provider via phone number 5037089256 and fax number 5032432429. The mailing address for Jeanette Marie Fanning is 9515 Se 74th Ave, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeanette Marie Fanning |
|---|---|
| Address | 9515 Se 74th Ave, Portland, Oregon |
| Phone Number | 5037089256 |
| Fax Number | 5032432429 |
| Sole Proprietor | Y |
| Credentials | QMHA |
NPI Number Detail
| NPI Number | 1912045139 |
|---|---|
| Provider Enumeration Date | 2007-02-01 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 9515 Se 74th Ave |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972221817 |
| Phone Number | 5037089256 |
| Fax Number | 5032432429 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
|
Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
|
Post Comment/ Review Below
What is the unique identification code assigned to Jeanette Marie Fanning by the Centers for Medicare & Medicaid Services?
The Jeanette Marie Fanning has been issued the NPI (National Provider Identifier) 1912045139. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Jeanette Marie Fanning?
The Jeanette Marie Fanning is physically situated at 9515 Se 74Th Ave, in the city of Portland, state of OR, with the postal code 972221817.
What is the area of specialization for Jeanette Marie Fanning, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Jeanette Marie Fanning is Community Based Residential Treatment Facility, Mental Illness, and the corresponding taxonomy code that categorizes this area of expertise is 320800000X.
On what date did the Jeanette Marie Fanning receive the assignment of its 1912045139 from the Centers for Medicare & Medicaid Services?
The Jeanette Marie Fanning was issued its 1912045139 by the Centers for Medicare & Medicaid Services on 2007-02-01.
When was the information pertaining to Jeanette Marie Fanning most recently updated or revised?
The details related to Jeanette Marie Fanning, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.