Organization
COUNTY OF JACKSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK JERRY ORNDOFF MS SOCIAL SCIENCE (DIRECTOR)
(541) 774-8200
Entity
Organization
Contact information
Practice address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Mailing address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251K00000X
Public Health or Welfare Agency
200250069NP
OR
261QA0005X
Ambulatory Family Planning Facility
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
OR
261QM2800X
Methadone Clinic
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043153
—
OR
05
—
096727
—
OR
05
—
096883
—
OR
05
—
193870
—
OR
05
—
320176
—
OR
Enumeration date
05/25/2006
Last updated
12/11/2014
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