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Organization
CHEROCREEK NATION
Active
Organization
CHEROCREEK NATION
Active
Other names
Chief Of Cherocreek Nation
Organization subpart
No
Provider details
NPI number
Authorized official
MINA CARABALLO PHD H.C. (OWNER ADMINISTRATOR)
(541) 393-9060
Entity
Organization
Contact information
Practice address
831 TALENT AVE, TALENT, OR 97540-9613
(541) 393-9060
Mailing address
831 TALENT AVE, TALENT, OR 97540-9613
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
002495302
NC
Other
Enumeration date
04/11/2014
Last updated
04/11/2014
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