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Ambulatory Health Care Facilities Clinic/Center Adolescent and Children Mental Health

Provider NPI: 1396071734

Organization Information:
Organization is not Subpart
Authorized Official:  REBECCA C AUSTEN  INTERIM DIRECTOR  541-265-0440

Practice Location:
Tel: 541-996-2311  Fax: 541-557-1643

Business Mailing Address:
36 SW NYE ST  NEWPORT, OR 97365-3821 US
Tel: 541-265-4179  Fax: 541-574-6252

NPI Information:
NPI: 1396071734
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N261QM0855XAmbulatory Health Care Facilities
Adolescent and Children Mental Health
N261QS1000XAmbulatory Health Care Facilities
Y261QF0400XAmbulatory Health Care Facilities

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 261QF0400X





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