Organization
LOOKING GLASS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMAELO EZEONWUKA (THERAPIST)
(541) 505-5484
Entity
Organization
Contact information
Practice address
1790 W 11TH AVE, EUGENE, OR 97402-3758
(541) 686-2611
Mailing address
1790 W 11TH AVE, EUGENE, OR 97402-3758
(541) 686-2611
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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