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Organization

ABC HOUSE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEE ASTIN GODWIN (EXECUTIVE DIRECTOR)
(541) 926-2203
Entity
Organization

Contact information

Practice address
228 SW 5TH AVE, ALBANY, OR 97321
(541) 926-2203
(541) 926-1378
Mailing address
PO BOX 68, ALBANY, OR 97321
(541) 926-2203
(541) 926-1378

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150785
OR
Enumeration date
01/12/2007
Last updated
09/27/2021
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