Organization
COLUMBIACARE SERVICES
Active
Other names
Cedar Bay
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR)
(541) 858-8170
Entity
Organization
Contact information
Practice address
1592 MONROE ST, NORTH BEND, OR 97459-3657
(541) 756-2048
(541) 756-2022
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504
(541) 858-8170
(541) 858-8167
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
889
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213056
—
OR
01
—
516824
CEDAR BAY SERVICE PAYMENT
OR
Enumeration date
02/15/2007
Last updated
05/13/2009
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