Organization
POLK COUNTY MENTAL HEALTH
Active
Other names
Polk County Mental Health Addiction Services
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MARIE KLEIN CADC-II QMHA BS (ADDICTIONS COUNSELOR)
(503) 623-9289
Entity
Organization
Contact information
Practice address
557 21ST ST SE, SALEM, OR 97301-6526
(503) 991-0226
Mailing address
557 21ST ST SE, SALEM, OR 97301-6526
(503) 991-0226
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
04-R-19
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-R-19
CADC-II ID NUMBER
OR
Enumeration date
04/04/2007
Last updated
08/14/2008
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