Organization
SOUTH LANE MENTAL HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW LEE YODER (ASSISTANT EXECUTIVE DIRECTOR)
(541) 942-3939
Entity
Organization
Contact information
Practice address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(541) 942-3939
(541) 942-9310
Mailing address
PO BOX 5, COTTAGE GROVE, OR 97424-0001
(541) 942-3939
(541) 942-9310
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019047
—
OR
Enumeration date
12/08/2006
Last updated
10/22/2024
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