Organization
CHEROCREEK NATION
Active
Other names
Chief Of Cherocreek Nation
Organization subpart
No
Provider details
NPI number
Authorized official
MINA CARABALLO PHD H.C. (OWNER ADMINISTRATOR)
(541) 393-9060
Entity
Organization
Contact information
Practice address
831 TALENT AVE, TALENT, OR 97540-9613
(541) 393-9060
Mailing address
831 TALENT AVE, TALENT, OR 97540-9613
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
002495302
NC
Other
Enumeration date
04/11/2014
Last updated
04/11/2014
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