Organization
JEFFERSON BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOB NIKKEL (EXECUTIVE DIRECTOR)
(541) 955-9565
Entity
Organization
Contact information
Practice address
550 NE E ST, GRANTS PASS, OR 97526-2326
(541) 955-9565
(541) 955-8290
Mailing address
550 NE E ST, GRANTS PASS, OR 97526-2326
(541) 955-9565
(541) 955-8290
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
119488
OR
Other
Enumeration date
07/30/2007
Last updated
08/11/2010
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