Organization
COW CREEK HEALTH & WELLNESS CTR
Active
Other names
Cow Creek Band of Umpqua Tribe of Indians
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J RONDEAU (CEO)
(541) 672-9405
Entity
Organization
Contact information
Practice address
2371 NE STEPHENS ST STE 200, ROSEBURG, OR 97470-1399
(541) 672-8533
(541) 672-4993
Mailing address
2371 NE STEPHENS ST STE 200, ROSEBURG, OR 97470-1399
(541) 672-8533
(541) 672-4993
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10-09-68U
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165772
—
OR
Enumeration date
12/12/2011
Last updated
12/12/2011
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