Organization
SOUTHERN OREGON BEHAVIORAL WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN J OXHOLM (MANAGER)
(541) 709-5056
Entity
Organization
Contact information
Practice address
1148 STANFORD AVE, MEDFORD, OR 97504-8924
(541) 591-7838
Mailing address
1609 E BARNETT RD, MEDFORD, OR 97504-8284
(541) 790-5056
(833) 639-4826
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
08/19/2020
Last updated
05/19/2021
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