Organization
SHANGRI-LA CORPORATION
Active
Organization
SHANGRI-LA CORPORATION
Active
Other names
Casa Rio
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN LENAY WINKLE (DIRECTOR)
(503) 581-1732
Entity
Organization
Contact information
Practice address
4472 DEL RIO PL SE, ALBANY, OR 97322-6233
(541) 924-5702
(541) 924-5703
Mailing address
4080 REED RD SE STE 150, SALEM, OR 97302-1335
(503) 581-1732
(503) 316-2299
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
519075
DMAP PROVIDER #
OR
Enumeration date
11/07/2012
Last updated
08/10/2020
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