Organization
GRACE WILLIAM HEALTH SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLAOLUWASUPO OJO DOL (EXECUTIVE DIRECTOR)
(443) 865-6503
Entity
Organization
Contact information
Practice address
714 MAIN STREET, SUITE #200, KLAMATH FALLS, OR 97601-6074
(541) 880-6031
Mailing address
714 MAIN STREET, SUITE #200, KLAMATH FALLS, OR 97601-6074
(443) 865-6503
(541) 887-2291
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500805936
—
OR
Enumeration date
07/16/2021
Last updated
06/12/2023
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