Organization
LA PINE KTC, LLC
Active
Organization
LA PINE KTC, LLC
Active
Parent organization
WHITE RABBIT PARTNERS
Other names
KLEAN La Pine
Organization subpart
Yes
Provider details
NPI number
Legal business name
WHITE RABBIT PARTNERS
Authorized official
MILTON PARHAM (CHIEF BUSINESS DEVELOPMENT OFFICER)
(509) 668-8008
Entity
Organization
Contact information
Practice address
16161 BURGESS RD, LA PINE, OR 97739-9533
(509) 668-8008
(503) 432-8913
Mailing address
16161 BURGESS RD, LA PINE, OR 97739-9533
(509) 668-8008
(503) 432-8913
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
OR
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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