Organization
LIFE'S INTENTION BACK TO BASICS INC.
Active
Other names
Life's Intention Back To Basics Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MADRIGAL-BATES LPCA, CADC II, QMHP (OWNER)
(541) 969-1941
Entity
Organization
Contact information
Practice address
920 SW FRAZER AVE STE 212, PENDLETON, OR 97801-2802
(541) 969-1941
Mailing address
920 SW FRAZER AVE STE 212, PENDLETON, OR 97801-2802
(541) 969-1941
(541) 429-4941
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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