Organization
G STREET INTEGRATED HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER OCKER (EXECUTIVE DIRECTOR)
(541) 735-9421
Entity
Organization
Contact information
Practice address
1435 G ST, SPRINGFIELD, OR 97477-4113
(541) 735-9420
(541) 747-9870
Mailing address
1435 G ST, SPRINGFIELD, OR 97477-4113
(541) 735-9420
(541) 747-9870
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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