Organization
COLUMBIA CARE SERVICES
Active
Other names
Bridgestone
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR)
(541) 858-8170
Entity
Organization
Contact information
Practice address
29549 SW VILLEBOIS DR S, WILSONVILLE, OR 97070-7329
(503) 427-0172
(503) 427-0798
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 585-8170
(541) 858-8167
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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