Office Based Addiction Treatment (obat) | |
36 Sw Nye St Newport OR 97365-3821 | |
(541) 265-0468 | |
(541) 265-0443 |
Full Name | Office Based Addiction Treatment (obat) |
---|---|
Speciality | Clinic/center |
Location | 36 Sw Nye St, Newport, Oregon |
Authorized Official Name and Position | Lesa Wagner (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 5412650445 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Office Based Addiction Treatment (obat) 36 Sw Nye St Newport OR 97365-3821 Ph: (541) 265-0468 | Office Based Addiction Treatment (obat) 36 Sw Nye St Newport OR 97365-3821 Ph: (541) 265-0468 |
NPI Number | 1013626233 |
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Provider Enumeration Date | 11/16/2022 |
Last Update Date | 07/12/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013626233 | NPI | - | NPPES |
500817645 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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