| Deschutes Wilderness Therapy | |
|
160 Scalehouse Loop Suite 160 Bend OR 97702-1284 | |
| (541) 312-4316 | |
| (541) 312-4350 |
| Full Name | Deschutes Wilderness Therapy |
|---|---|
| Speciality | Psychiatric Residential Treatment Facility |
| Location | 160 Scalehouse Loop, Bend, Oregon |
| Authorized Official Name and Position | Laura J Brown (VP OF REVENUE CYCLE MANAGEMENT) |
| Authorized Official Contact | 6618294060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deschutes Wilderness Therapy 5500 Ming Ave Ste 410 Bakersfield CA 93309-4631 Ph: (661) 622-4132 | Deschutes Wilderness Therapy 160 Scalehouse Loop Suite 160 Bend OR 97702-1284 Ph: (541) 312-4316 |
| NPI Number | 1699161745 |
|---|---|
| Provider Enumeration Date | 04/15/2015 |
| Last Update Date | 06/20/2023 |
| Certification Date | 06/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699161745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 0222 (Oregon) | Secondary |
| 323P00000X | Psychiatric Residential Treatment Facility | 0222 (Oregon) | Primary |
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