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Organization
ORTC, LLC
Active
Organization
ORTC, LLC
Active
Parent organization
BEND TREATMENT CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEND TREATMENT CENTER
Authorized official
DANA JORGENSEN (AUTHORIZED OFFICIAL)
(541) 322-1794
Entity
Organization
Contact information
Practice address
155 NE REVERE AVE STE 150, BEND, OR 97701-4147
(541) 617-4544
(541) 749-2126
Mailing address
155 NE REVERE AVE STE 150, BEND, OR 97701-4147
(541) 617-4544
(541) 749-2126
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38D2134657
—
OR
Enumeration date
10/24/2017
Last updated
09/16/2021
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