Organization
NIBBUS COMBINED CARE LLC
Active
Parent organization
NIBBUS COMBINED CARE LLC
Other names
Brycen's House RTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
NIBBUS COMBINED CARE LLC
Authorized official
BRENDA WATSON (OWNER/EXECUTIVE DIRECTOR)
(458) 225-9993
Entity
Organization
Contact information
Practice address
805 AMERMAN DR, PHOENIX, OR 97535-7729
(458) 291-1603
Mailing address
1175 E MAIN ST STE 2F, MEDFORD, OR 97504-7457
(458) 225-9993
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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