Organization
CHATEAU ANGEL ROSE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY R ELROD PEER SUPPORT (OWNER)
(541) 891-9861
Entity
Organization
Contact information
Practice address
3882 RIO VISTA WAY, KLAMATH FALLS, OR 97603-7727
(541) 891-9861
Mailing address
3882 RIO VISTA WAY, KLAMATH FALLS, OR 97603-7727
(541) 891-9861
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/18/2024
Last updated
05/18/2024
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