Organization
COMMUNITY LIFE COUNSELING SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LEE (PROGRAM DIRECTOR)
(541) 633-7032
Entity
Organization
Contact information
Practice address
154 S MAIN ST, INDEPENDENCE, OR 97351-2005
(541) 633-7032
Mailing address
1050 CRATER LAKE AVE STE A, MEDFORD, OR 97504-6223
(541) 633-7032
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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