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Organization

COLUMBIACARE SERVICES

Active
Other names
Court Royal
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR)
(541) 858-8170
Entity
Organization

Contact information

Practice address
315 W 6TH ST, THE DALLES, OR 97058-1852
(541) 647-0865
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
(541) 858-8167

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500641372
OR
Enumeration date
09/02/2011
Last updated
03/06/2012
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