Organization
KAIROS NORTHWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN BOLDT M.S (OPERATIONS DIRECTOR)
(541) 474-5579
Entity
Organization
Contact information
Practice address
210 TACOMA ST, GRANTS PASS, OR 97526-9370
(541) 467-3302
Mailing address
715 SW RAMSEY AVE, GRANTS PASS, OR 97527-5500
(541) 956-4943
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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