Organization
BOB BELLONI RANCH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER LANGLIE (EXECUTIVE DIRECTOR)
(541) 269-0321
Entity
Organization
Contact information
Practice address
320 CENTRAL AVE STE 406, COOS BAY, OR 97420-2241
(541) 269-0321
Mailing address
320 CENTRAL AVE STE 406, COOS BAY, OR 97420-2241
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
43
OR
Other
Enumeration date
10/15/2009
Last updated
12/02/2013
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