Organization
INNERVISION HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY DECHELLE WIGGINS (DIRECTOR)
(336) 314-7105
Entity
Organization
Contact information
Practice address
681 COTTAGE ST NE, SALEM, OR 97301-2419
(336) 314-7105
Mailing address
681 COTTAGE ST NE, SALEM, OR 97301-2419
(336) 314-7105
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
10/23/2024
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