# CHEROCREEK NATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chief Of Cherocreek Nation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598184087
- **Authorized official:** MINA CARABALLO PHD H.C. (OWNER ADMINISTRATOR)
- **Authorized official phone:** (541) 393-9060

## Contact information

- **Practice address:** 831 TALENT AVE, TALENT, OR 97540-9613
- **Practice address phone:** (541) 393-9060
- **Mailing address:** 831 TALENT AVE, TALENT, OR 97540-9613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 002495302 | NC | Yes |

## Other

- **Enumeration date:** 04/11/2014
- **Last updated:** 04/11/2014