Organization
INTAWELL BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY DAVIS MARTIN (OWNER)
(541) 668-5238
Entity
Organization
Contact information
Practice address
895 E COYOTE SPRINGS RD, SISTERS, OR 97759-9518
(541) 668-5238
Mailing address
895 E COYOTE SPRINGS RD, SISTERS, OR 97759-9518
(541) 668-5238
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/24/2022
Last updated
06/24/2022
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