Organization
UNION COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY A BURGESS (ADMINISTRATIVE OFFICER)
(541) 963-1001
Entity
Organization
Contact information
Practice address
1106 K AVE, LA GRANDE, OR 97850-2131
(541) 963-1001
(541) 963-1079
Mailing address
1106 K AVE, LA GRANDE, OR 97850-2131
(541) 963-1001
(541) 963-1079
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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