Organization
COLUMBIACARE SERVICES
Active
Other names
Coos Crisis Resolution Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR)
(541) 858-8170
Entity
Organization
Contact information
Practice address
1885 THOMPSON RD, COOS BAY, OR 97420-2152
(541) 266-8480
(541) 266-8479
Mailing address
1175 E MAIN ST, 1B, MEDFORD, OR 97504-7499
(541) 858-8170
(541) 858-8167
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
545
OR
385H00000X
Respite Care
545
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312033
—
OR
Enumeration date
10/09/2006
Last updated
03/28/2008
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