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Organization
FAMILY SOLUTIONS
Active
Organization
FAMILY SOLUTIONS
Active
Other names
Southern Oregon Child Study and Treatment Center, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY J PROVENCIO (EXECUTIVE DIRECTOR)
(541) 414-1720
Entity
Organization
Contact information
Practice address
201 W MAIN ST STE 4B, MEDFORD, OR 97501-2734
(541) 414-1720
(541) 414-1724
Mailing address
1836 FREMONT ST, ASHLAND, OR 97520-2537
(541) 414-1720
(541) 414-1724
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
323P00000X
Psychiatric Residential Treatment Facility
—
NULL
Other
Enumeration date
09/25/2006
Last updated
11/29/2023
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