Organization
JACKSON COUNTY COMMUNITY JUSTICE
Active
Other names
Juvenile Division CBT Program
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD SCOTT MICKEY (SUPERVISOR)
(541) 774-4812
Entity
Organization
Contact information
Practice address
609 W 10TH ST, MEDFORD, OR 97501-3106
(541) 774-4812
(541) 774-4888
Mailing address
609 W 10TH ST, MEDFORD, OR 97501-3106
(541) 774-4812
(541) 774-4888
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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