| Cow Creek Health & Wellness Ctr | |
|
2371 Ne Stephens St Ste 200 Roseburg OR 97470-1399 | |
| (541) 672-8533 | |
| (541) 672-4993 |
| Full Name | Cow Creek Health & Wellness Ctr |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2371 Ne Stephens St Ste 200, Roseburg, Oregon |
| Authorized Official Name and Position | Michael J Rondeau (CEO) |
| Authorized Official Contact | 5416729405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cow Creek Health & Wellness Ctr 2371 Ne Stephens St Ste 200 Roseburg OR 97470-1399 Ph: (541) 672-8533 | Cow Creek Health & Wellness Ctr 2371 Ne Stephens St Ste 200 Roseburg OR 97470-1399 Ph: (541) 672-8533 |
| NPI Number | 1205104718 |
|---|---|
| Provider Enumeration Date | 12/12/2011 |
| Last Update Date | 12/12/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205104718 | NPI | - | NPPES |
| 165772 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 10-09-68U (Oregon) | Primary |
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