Organization
BEACON YOUTH & PREVENTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY LYNN BUTLER (EXECUTIVE DIRECTOR)
(971) 600-3864
Entity
Organization
Contact information
Practice address
3000 MARKET ST NE, SUITE 528, SALEM, OR 97301-1882
(971) 600-3864
Mailing address
3000 MARKET ST NE, SUITE 528, SALEM, OR 97301-1882
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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