Organization
WALLOWA VALLEY CENTER FOR WELLNESS
Active
Organization
WALLOWA VALLEY CENTER FOR WELLNESS
Active
Other names
Wallowa River House
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTAY JETT (EXECUTIVE DIRECTOR)
(541) 426-4524
Entity
Organization
Contact information
Practice address
601 WHISKEY CREEK RD, WALLOWA, OR 97885-7129
(541) 886-3142
Mailing address
PO BOX 268, ENTERPRISE, OR 97828-0268
(541) 426-4524
(541) 426-3035
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
984
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
517796
—
OR
Enumeration date
12/11/2008
Last updated
11/03/2024
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