Organization
GRANDE RONDE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGGEN M BROGOITTI (OFFICE MANAGER)
(541) 962-0162
Entity
Organization
Contact information
Practice address
1101 I AVE, LA GRANDE, OR 97850-2043
(541) 962-0162
Mailing address
1101 I AVE, LA GRANDE, OR 97850-2043
(541) 962-0162
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
MD18191
OR
Other
Enumeration date
12/14/2007
Last updated
08/28/2008
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