Organization
COLUMBIACARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE DAVID SEWITSKY (FINANCE MANAGER)
(541) 858-8170
Entity
Organization
Contact information
Practice address
29841 HILLCREST ST, GOLD BEACH, OR 97444-8714
(541) 858-8170
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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