Full Name | |
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Speciality | Community/behavioral Health |
Location | 422 N Main St, Condon, Oregon |
Authorized Official Name and Position | Shannon Boor (BUSINESS OPERATIONS MANAGER) |
Authorized Official Contact | 5416769161 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 469 Heppner OR 97836-0469 Ph: (541) 676-9161 | 422 N Main St Condon OR 97823-7651 Ph: (541) 384-2666 |
NPI Number | 1518394345 |
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Provider Enumeration Date | 10/11/2013 |
Last Update Date | 10/11/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518394345 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |