Organization
REVITALIZE WELLNESS CENTER
Active
Parent organization
COLUMBIA COMMUNITY MENTAL HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLUMBIA COMMUNITY MENTAL HEALTH
Authorized official
TODD JACOBSON (EXECUTIVE DIRECTOR)
(503) 397-5211
Entity
Organization
Contact information
Practice address
51577 COLUMBIA RIVER HWY, SUITE C, SCAPPOOSE, OR 97056-8409
(503) 396-4807
(503) 397-5373
Mailing address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(503) 397-5211
(503) 397-5373
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
OR
Other
Enumeration date
01/22/2016
Last updated
08/28/2024
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