Organization
PIONEER GUEST HOME II, INC
Active
Organization
PIONEER GUEST HOME II, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL PERRY RODDEY OWNER (LICENSED ADMINISTRATOR)
(541) 263-0897
Entity
Organization
Contact information
Practice address
101 E MAIN ST, ENTERPRISE, OR 97828-1381
(541) 426-4222
(541) 426-6550
Mailing address
PO BOX 326, ENTERPRISE, OR 97828-0326
(541) 426-4222
(541) 426-6550
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
300024
OR
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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