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Organization
ROYAL AVE PROGRAM
Active
Organization
ROYAL AVE PROGRAM
Active
Parent organization
SHELTERCARE
Other names
Sheltercare
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHELTERCARE
Authorized official
ERIN BONNER (ASSISTANT EXECTIVE DIRECTOR)
(541) 686-1262
Entity
Organization
Contact information
Practice address
499 W 4TH AVE, EUGENE, OR 97401-2505
(541) 686-1262
(541) 686-0359
Mailing address
780 HIGHWAY 99 N, EUGENE, OR 97402-2301
(541) 686-1262
(541) 686-1262
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233701
—
OR
Enumeration date
05/10/2012
Last updated
05/10/2012
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