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Organization
SOUTH LANE MENTAL HEALTH SERVICES, INC
Active
Organization
SOUTH LANE MENTAL HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THERESE NADINE MASTIN MA (QUALITY MANAGEMENT DIRECTOR)
(541) 767-4176
Entity
Organization
Contact information
Practice address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(541) 942-3939
(541) 942-9310
Mailing address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(541) 942-3939
(541) 942-9310
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
102491-83
OR
Other
Enumeration date
08/25/2017
Last updated
07/21/2022
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