Organization
POLK ADOLESCENT DAY TREATMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL STRASSER MC (EXECUTIVE DIRECTOR)
(503) 623-5588
Entity
Organization
Contact information
Practice address
2200 E ELLENDALE, DALLAS, OR 97338
(503) 623-5588
(503) 623-5588
Mailing address
2200 E ELLENDALE, DALLAS, OR 97338
(503) 623-5588
(503) 623-4729
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
297982
PROVIDER NUMBER
OR
Enumeration date
11/29/2006
Last updated
03/07/2013
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