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Organization

DROP THESIS

Active
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Organization

DROP THESIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SERENA DIETRICH (AUTHORIZED OFFICIAL)
(458) 202-7111
Entity
Organization

Contact information

Practice address
505 NW FRANKLIN AVE, BEND, OR 97703-2807
(458) 202-7111
Mailing address
505 NW FRANKLIN AVE, BEND, OR 97703-2807
(458) 202-7111

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—

Other

Enumeration date
06/21/2024
Last updated
06/21/2024
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