Organization
COMMUNITY WORKS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONNIE R EIDSON (DIRECTOR OF BUSINESS)
(541) 779-2393
Entity
Organization
Contact information
Practice address
201 W MAIN ST, #3D, MEDFORD, OR 97501-2744
(541) 779-2393
(541) 779-3317
Mailing address
201 W MAIN ST, #3D, MEDFORD, OR 97501-2744
(541) 779-2393
(541) 779-3317
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164979
—
OR
Enumeration date
05/31/2007
Last updated
05/09/2013
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