Organization
MT EMILY SAFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE AKERS (OFFICE ASSISTANT)
(541) 963-0602
Entity
Organization
Contact information
Practice address
2107 3RD ST, LA GRANDE, OR 97850-2242
(541) 963-0602
(541) 962-0345
Mailing address
PO BOX 146, LA GRANDE, OR 97850-0146
(541) 963-0602
(541) 962-0345
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
67369182
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287127
—
OR
01
—
57169744
BLUE CROSS BLUE SHIELD
OR
Enumeration date
04/03/2007
Last updated
02/19/2010
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