Jackson County Child Abuse Task Force Inc | |
816 West 10th Street Medford OR 97501 | |
(541) 734-5437 | |
(541) 618-1094 |
Full Name | Jackson County Child Abuse Task Force Inc |
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Speciality | Counselor - Mental Health |
Location | 816 West 10th Street, Medford, Oregon |
Authorized Official Name and Position | Tammy L. Pitzen (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5417345437 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jackson County Child Abuse Task Force Inc 816 W. 10th Street Medford OR 97501 Ph: (541) 734-5437 | Jackson County Child Abuse Task Force Inc 816 West 10th Street Medford OR 97501 Ph: (541) 734-5437 |
NPI Number | 1114594264 |
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Provider Enumeration Date | 06/08/2021 |
Last Update Date | 06/08/2021 |
Certification Date | 06/08/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114594264 | NPI | - | NPPES |
232518 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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