Organization
COLUMBIACARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DAVID SEWITSKY (FINANCE MANAGER)
(541) 858-8170
Entity
Organization
Contact information
Practice address
2575 WESTGATE BLDG E, PENDLETON, OR 97801-9613
(541) 858-8170
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
86761393
OR
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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