Organization
VICI HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTON SACKETT (FOUNDER, CEO)
(650) 285-7209
Entity
Organization
Contact information
Practice address
282 SW MT ST HELENS ST, MCMINNVILLE, OR 97128-5590
(650) 285-7209
Mailing address
282 SW MT ST HELENS ST, MCMINNVILLE, OR 97128-5590
(650) 285-7209
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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