Open Space | |
758 Nw 1st St Enterprise OR 97828-1527 | |
(541) 426-4502 | |
Not Available |
Full Name | Open Space |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 758 Nw 1st St, Enterprise, Oregon |
Authorized Official Name and Position | Keli Jean Dennis (COO) |
Authorized Official Contact | 5414264502 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Open Space 603 Medical Pkwy Enterprise OR 97828-5124 Ph: (541) 426-4502 | Open Space 758 Nw 1st St Enterprise OR 97828-1527 Ph: (541) 426-4502 |
NPI Number | 1518426493 |
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Provider Enumeration Date | 03/19/2019 |
Last Update Date | 09/12/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518426493 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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