Organization
BIRCH GROVE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE HOLLAND-KLEIN LCSW (OWNER)
(503) 580-7336
Entity
Organization
Contact information
Practice address
3787 RIVER RD N STE C, KEIZER, OR 97303-4899
(503) 580-7336
Mailing address
542 DELMAR DR N, SALEM, OR 97303-6020
(907) 388-4689
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4684
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164591681
NPI
—
Enumeration date
04/27/2018
Last updated
04/27/2018
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