| Polk County Mental Health Addiction Services | |
|
557 21st St Se Salem OR 97301-6526 | |
| (503) 991-0226 | |
| Not Available |
| Full Name | Polk County Mental Health Addiction Services |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 557 21st St Se, Salem, Oregon |
| Authorized Official Name and Position | Susan Marie Klein (ADDICTIONS COUNSELOR) |
| Authorized Official Contact | 5036239289 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Polk County Mental Health Addiction Services 557 21st St Se Salem OR 97301-6526 Ph: (503) 991-0226 | Polk County Mental Health Addiction Services 557 21st St Se Salem OR 97301-6526 Ph: (503) 991-0226 |
| NPI Number | 1295857977 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 08/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295857977 | NPI | - | NPPES |
| 04-R-19 | Other | OR | CADC-II ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 04-R-19 (Oregon) | Primary |
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