Organization
JCMH - HAZEL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON A NORMAN LPC (PROGRAM MANAGER)
(541) 737-3952
Entity
Organization
Contact information
Practice address
1911 HAZEL AVE, MEDFORD, OR 97501-1630
(541) 734-3950
(541) 734-3960
Mailing address
1911 HAZEL AVE, MEDFORD, OR 97501-1630
(541) 734-3950
(541) 734-3960
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
514136
OR
Other
Enumeration date
03/23/2012
Last updated
03/23/2012
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