| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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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