| Resolutions Creative Conflict Management, Inc | |
|
2052 Ne 4th St Bend OR 97701-3825 | |
| (541) 383-2004 | |
| (541) 383-2013 |
| Full Name | Resolutions Creative Conflict Management, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2052 Ne 4th St, Bend, Oregon |
| Authorized Official Name and Position | Betty Jo Groshong (THERAPIST) |
| Authorized Official Contact | 5413832004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resolutions Creative Conflict Management, Inc 2052 Ne 4th St Bend OR 97701-3825 Ph: (541) 383-2004 | Resolutions Creative Conflict Management, Inc 2052 Ne 4th St Bend OR 97701-3825 Ph: (541) 383-2004 |
| NPI Number | 1184800187 |
|---|---|
| Provider Enumeration Date | 01/21/2008 |
| Last Update Date | 04/06/2010 |
| Medicare PECOS PAC ID | 0143383687 |
|---|---|
| Medicare Enrollment ID | O20090109000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184800187 | NPI | - | NPPES |
| 1245241397 | Other | OR | NPI FOR BETTY GROSHONG |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | L3785 (Oregon) | Primary |
| Provider Name | Betty J Groshong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245241397 PECOS PAC ID: 1850398819 Enrollment ID: I20061104000046 |
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