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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