Organization
GOLDEN RULE REENTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHASTA LYNN RODRIGUEZ PSS/JITHW (HEAD CASE MANAGER)
(541) 930-8932
Entity
Organization
Contact information
Practice address
715 W MAIN ST, MEDFORD, OR 97501-2924
(541) 930-8933
Mailing address
2305 ASHLAND ST # C-350, ASHLAND, OR 97520-3777
(541) 693-0893
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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