Organization
CHILDERNS FARM HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA TAYLOR COPELAND (LEAD TTL POWERS)
(541) 750-1121
Entity
Organization
Contact information
Practice address
2820 SE GLENN ST, CORVALLIS, OR 97333-2121
(541) 750-1121
Mailing address
2820 SE GLENN ST, CORVALLIS, OR 97333-2121
(541) 750-1121
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
OR
Other
Enumeration date
05/23/2007
Last updated
08/22/2020
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