Organization
CARROLLS GROUP CARE HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL V CARROLL (OWNER)
(503) 399-0189
Entity
Organization
Contact information
Practice address
293 14TH ST SE, SALEM, OR 97301-4109
(503) 399-0189
(503) 581-8799
Mailing address
PO BOX 12035, SALEM, OR 97309-0035
(503) 399-0189
(503) 581-8799
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
508201
OR
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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