| Lilac Wellness And Counseling | |
|
2651 Commercial St Se Ste 1 Salem OR 97302-4872 | |
| (503) 587-9937 | |
| (503) 994-8049 |
| Full Name | Lilac Wellness And Counseling |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2651 Commercial St Se Ste 1, Salem, Oregon |
| Authorized Official Name and Position | Pam Connell (ADMINISTRATION) |
| Authorized Official Contact | 5035879937 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lilac Wellness And Counseling 2651 Commercial St Se Ste 1 Salem OR 97302-4872 Ph: (503) 587-9937 | Lilac Wellness And Counseling 2651 Commercial St Se Ste 1 Salem OR 97302-4872 Ph: (503) 587-9937 |
| NPI Number | 1104322841 |
|---|---|
| Provider Enumeration Date | 04/02/2018 |
| Last Update Date | 12/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104322841 | NPI | - | NPPES |
| 500688899 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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