Intentional Living Programs, Llc | |
405 W 4th St The Dalles OR 97058-1305 | |
(541) 298-8227 | |
(541) 769-0153 |
Full Name | Intentional Living Programs, Llc |
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Speciality | Social Worker - Clinical |
Location | 405 W 4th St, The Dalles, Oregon |
Authorized Official Name and Position | Sandra Bartholomew (OWNER) |
Authorized Official Contact | 5412988227 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Intentional Living Programs, Llc 405 W 4th St The Dalles OR 97058-1305 Ph: (541) 298-8227 | Intentional Living Programs, Llc 405 W 4th St The Dalles OR 97058-1305 Ph: (541) 298-8227 |
NPI Number | 1013550441 |
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Provider Enumeration Date | 10/17/2019 |
Last Update Date | 10/17/2019 |
Identifier | Type | State | Issuer |
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1013550441 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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