Organization
KLAMATH YOUTH DEVELOPMENT CENTER
Active
Organization
KLAMATH YOUTH DEVELOPMENT CENTER
Active
Other names
Klamath Child and Family Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNY ELLEN WHEELER BS, CADC I (TRANSITION CORDINATOR SBS)
(541) 591-5604
Entity
Organization
Contact information
Practice address
2210 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6418
(541) 883-1030
Mailing address
2210 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6418
(541) 883-1030
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223354
—
OR
Enumeration date
10/04/2013
Last updated
10/04/2013
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