Organization
PIONEER GUEST HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL PERRY RODDEY MSGT/ USMC RETIRED (LICENSED ADMINISTRATOR)
(541) 426-4222
Entity
Organization
Contact information
Practice address
101 E MAIN ST, BOX 326, ENTERPRISE, OR 97828-1381
(541) 426-4222
(541) 426-6550
Mailing address
101 E MAIN ST, P.O. BOX 326, ENTERPRISE, OR 97828-1381
(541) 426-4222
(541) 426-6550
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
OR
Other
Enumeration date
11/26/2008
Last updated
11/26/2008
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