Organization
OLTHYME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL SCOTT MACK (OWNER)
(541) 289-8941
Entity
Organization
Contact information
Practice address
30803 JEPPESON LN, HERMISTON, OR 97838-6222
(541) 289-8941
(541) 289-8942
Mailing address
30803 JEPPESON LN, HERMISTON, OR 97838-6222
(541) 289-8941
(541) 289-8942
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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