Organization
COLUMBIACARE SERVICES
Active
Other names
Lincoln Park
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT BECKETT (EXECUTIVE DIRECTOR)
(541) 858-8170
Entity
Organization
Contact information
Practice address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Mailing address
2409 SE 139TH AVE, PORTLAND, OR 97233-2041
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
810609831
OR
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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