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Organization
JACKSON COUNTY COMMUNITY JUSTICE
Active
Organization
JACKSON COUNTY COMMUNITY JUSTICE
Active
Other names
Juvenile Division CBT Program
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD SCOTT MICKEY (SUPERVISOR)
(541) 774-4812
Entity
Organization
Contact information
Practice address
609 W 10TH ST, MEDFORD, OR 97501-3106
(541) 774-4812
(541) 774-4888
Mailing address
609 W 10TH ST, MEDFORD, OR 97501-3106
(541) 774-4812
(541) 774-4888
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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