Organization
YOUTH VILLAGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MCCOLLOUGH (REGIONAL SUPERVISOR)
(541) 516-6349
Entity
Organization
Contact information
Practice address
2659 SW 4TH ST, SUITE 102, REDMOND, OR 97756-6406
(541) 516-6349
Mailing address
2659 SW 4TH ST, SUITE 102, REDMOND, OR 97756-6406
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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