Organization
THE CONFEDERATED TRIBES OF THE WARM SPRINGS RESERVATION OF OREGON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE STACONA (SECRETARY/TREASURER-CEO)
(541) 553-3232
Entity
Organization
Contact information
Practice address
1115 WASCO ST., WARM SPRINGS, OR 97761-3001
(541) 553-3205
(541) 553-4900
Mailing address
P.O. BOX C, WARM SPRINGS, OR 97761-3001
(541) 553-3205
(541) 553-4900
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
136064
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136064
TARGETED CASE MANAGEMENT
OR
Enumeration date
11/02/2006
Last updated
08/04/2020
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