Organization
COLUMBIACARE SERVICES
Active
Other names
Kellogg Creek
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR)
(541) 858-8170
Entity
Organization
Contact information
Practice address
4199 SE KING RD, MILWAUKIE, OR 97222-5892
(503) 786-3830
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
(541) 858-8167
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
08/15/2011
Last updated
08/15/2011
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