| Bob Belloni Ranch Inc. | |
|
320 Central Ave Ste 406 Coos Bay OR 97420-2241 | |
| (541) 269-0321 | |
| (541) 267-0785 |
| Full Name | Bob Belloni Ranch Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 320 Central Ave Ste 406, Coos Bay, Oregon |
| Authorized Official Name and Position | Thujee Paul Lhendup (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5412690321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bob Belloni Ranch Inc. 320 Central Ave Ste 406 Coos Bay OR 97420-2241 Ph: (541) 269-0321 | Bob Belloni Ranch Inc. 320 Central Ave Ste 406 Coos Bay OR 97420-2241 Ph: (541) 269-0321 |
| NPI Number | 1376165068 |
|---|---|
| Provider Enumeration Date | 05/15/2020 |
| Last Update Date | 05/15/2020 |
| Certification Date | 05/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376165068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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