Organization
COLUMBIACARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE DAVID SEWITSKY (FINANCE MANAGER)
(541) 858-8170
Entity
Organization
Contact information
Practice address
2211 CLEAR VUE LN, SPRINGFIELD, OR 97477-1373
(503) 654-5678
(503) 654-1236
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504
(541) 858-8170
(541) 858-8167
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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