Organization
SHANGRI-LA CORPORATION
Active
Other names
Old Oak
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HELEN E HONEY (CFO)
(503) 581-1732
Entity
Organization
Contact information
Practice address
1206 OLD OAK DR SE, ALBANY, OR 97322-6655
(541) 926-8207
(541) 926-5781
Mailing address
4080 REED RD SE STE 150, SALEM, OR 97302-1335
(503) 581-1732
(503) 316-2299
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
516706
DMAP PROVIDER #
OR
Enumeration date
11/06/2012
Last updated
11/06/2012
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