| Sriponya Collective | |
|
1080 Se Bluegrass Ln Madras OR 97741-1642 | |
| (541) 408-0968 | |
| Not Available |
| Full Name | Sriponya Collective |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1080 Se Bluegrass Ln, Madras, Oregon |
| Authorized Official Name and Position | Jennifer Joyce Eales (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5414080968 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sriponya Collective Po Box 412 Madras OR 97741-0052 Ph: (541) 408-0968 | Sriponya Collective 1080 Se Bluegrass Ln Madras OR 97741-1642 Ph: (541) 408-0968 |
| NPI Number | 1699535096 |
|---|---|
| Provider Enumeration Date | 03/21/2024 |
| Last Update Date | 03/21/2024 |
| Certification Date | 03/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699535096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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