Provider Demographics
NPI:1487070181
Name:UNITED COMMUNITY ACTION NETWORK
Entity type:Organization
Organization Name:UNITED COMMUNITY ACTION NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-672-3421
Mailing Address - Street 1:280 NE KENNETH FORD DR
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-1034
Mailing Address - Country:US
Mailing Address - Phone:541-492-3508
Mailing Address - Fax:
Practice Address - Street 1:280 NE KENNETH FORD DR
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-1034
Practice Address - Country:US
Practice Address - Phone:541-492-3508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500669799Medicaid