Organization
POWER HOUSE DETOX
Active
Parent organization
THE POWER HOUSE RESIDENTIAL DRUG TREATMENT CENTER INC
Other names
PHD
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE POWER HOUSE RESIDENTIAL DRUG TREATMENT CENTER INC
Authorized official
MELISSA KIM HOMAN CADC II, CRM (REGIONAL DIRECTOR)
(541) 720-4636
Entity
Organization
Contact information
Practice address
3955 SALMON RIVER HWY, OTIS, OR 97368-9778
(541) 720-4636
(888) 977-2106
Mailing address
3955 SALMON RIVER HWY, OTIS, OR 97368-9778
(541) 720-4636
(888) 977-2106
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
700119
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500667339
—
OR
Enumeration date
06/12/2018
Last updated
06/16/2018
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