| Polk County Alcohol And Drug | |
|
182 Sw Academy Suite #304 Dallas OR 97338-1922 | |
| (503) 623-9289 | |
| (503) 831-1726 |
| Full Name | Polk County Alcohol And Drug |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 182 Sw Academy, Dallas, Oregon |
| Authorized Official Name and Position | Greg P Hansen (POLK COUNTY ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 5036238173 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Polk County Alcohol And Drug 182 Sw Academy St Suite #310 Polk County Alcohol And Drug Dallas OR 97338-1922 Ph: (503) 623-9317 | Polk County Alcohol And Drug 182 Sw Academy Suite #304 Dallas OR 97338-1922 Ph: (503) 623-9289 |
| NPI Number | 1720013071 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720013071 | NPI | - | NPPES |
| 132001 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CERTIFICATE OF APPRO (Oregon) | Primary |
Oregon Recovery Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 147 Sw Court St, Dallas, OR 97338 Phone: 503-304-4358 | |
Polk County Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, Suite304, Dallas, OR 97338 Phone: 503-623-9289 Fax: 503-831-1726 | |
Clear Paths Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 171 Sw Court, Dallas, OR 97338 Phone: 503-831-1423 Fax: 503-831-1573 | |
Polk County Health And Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, Dallas, OR 97338 Phone: 503-623-9289 | |
Polk County Mental Health Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 182 Sw Academy, Suite 304, Dallas, OR 97338 Phone: 503-623-9289 Fax: 503-831-1726 | |
Polk County Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, Suite 304, Dallas, OR 97338 Phone: 503-623-9289 Fax: 503-831-1726 | |
Thrive Therapy & Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 Ne Evergreen Ave, Dallas, OR 97338 Phone: 503-383-1422 |