Organization
G STREET INTEGRATED HEALTH
Active
Parent organization
G STREET INTEGRATED HEALTH
Other names
Kaitlin's House
Organization subpart
Yes
Provider details
NPI number
Legal business name
G STREET INTEGRATED HEALTH
Authorized official
JENNIFER OCKER (CEO)
(541) 735-9421
Entity
Organization
Contact information
Practice address
1601 I ST, SPRINGFIELD, OR 97477-4163
(541) 735-9420
(541) 747-9870
Mailing address
PO BOX 163, SPRINGFIELD, OR 97477-0024
(541) 735-9420
(541) 747-9870
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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