# JEFFERSON BEHAVIORAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861575912
- **Authorized official:** MRS. ARLENE LOGAN LCSW (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (541) 955-9565

## Contact information

- **Practice address:** 223 SE M ST, HAMILTON HOUSE ANNEX, GRANTS PASS, OR 97526-3133
- **Practice address phone:** (541) 955-9565
- **Practice address fax:** (541) 955-8290
- **Mailing address:** 223 SE M ST, HAMILTON HOUSE ANNEX, GRANTS PASS, OR 97526-3133
- **Mailing address phone:** (541) 955-9565
- **Mailing address fax:** (541) 955-8290

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 165300 | — | OR |