Power House Detox
Rehabilitation, Substance Use Disorder Unit in Otis, OR. Organization (NPI-2).
NPI number1982197182
StatusActive
Last updated in NPPESJun 16, 2018
Details
- NPI
- 1982197182
- Entity type
- Organization (NPI-2)
- Legal business name
- Power House Detox
- Organization subpart
- Yes
- Enumeration date
- Jun 12, 2018
- Last updated
- Jun 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 276400000X | Rehabilitation, Substance Use Disorder Unit | 700119 | OR | Yes |
Other names
- Phd (Other Name)
Practice location
3955 Salmon River HwyOtis, OR 97368-9778
Phone 541-720-4636 · Fax 888-977-2106
Mailing address
3955 Salmon River HwyOtis, OR 97368-9778
Phone 541-720-4636 · Fax 888-977-2106
Authorized official
Melissa Kim Homan
Regional Director
5417204636
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