| Organization Name: | DEPARTMENT OF VETERANS AFFAIRS |
| NPI Number: | 1386714053 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MAX E MCINTOSH (DIRECTOR) |
| Mailing Address: | 8495 Crater Lake Hwy White City |
| State: | OR US |
| Postal Code: | 975033011 |
| Phone Number: | 5418262111 |
| Fax Number: | 5418307485 |
| NPI Enumeration Date: | 11/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0850X |
| License Number: | AA426809 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Mental Health |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |