| Mill Street Psychiatric | |
|
1404 Se Mill St Roseburg OR 97470-4008 | |
| (541) 492-1340 | |
| (541) 492-1339 |
| Full Name | Mill Street Psychiatric |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1404 Se Mill St, Roseburg, Oregon |
| Authorized Official Name and Position | Robert Harry Luck (OWNER) |
| Authorized Official Contact | 5414921340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mill Street Psychiatric 1404 Se Mill St Roseburg OR 97470-4008 Ph: (541) 492-1340 | Mill Street Psychiatric 1404 Se Mill St Roseburg OR 97470-4008 Ph: (541) 492-1340 |
| NPI Number | 1720329329 |
|---|---|
| Provider Enumeration Date | 03/06/2013 |
| Last Update Date | 03/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720329329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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