Organization
CHURCH AT THE PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN E ROBERTSON PSYD (CHIEF CLINICAL OFFICER)
(503) 459-7685
Entity
Organization
Contact information
Practice address
1280 CENTER ST NE, SALEM, OR 97301-4113
(503) 507-4992
Mailing address
2111 FRONT ST NE STE 1-103, SALEM, OR 97301-0779
(503) 459-7685
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
282J00000X
Religious Nonmedical Health Care Institution
Primary
—
—
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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