| Lorna Byrne Middle School Sbhc | |
|
101 S Junction Ave Cave Junction OR 97523-9006 | |
| (541) 592-6978 | |
| (541) 592-6702 |
| Full Name | Lorna Byrne Middle School Sbhc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 101 S Junction Ave, Cave Junction, Oregon |
| Authorized Official Name and Position | Richard Booth (CEO) |
| Authorized Official Contact | 5414713455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lorna Byrne Middle School Sbhc 1701 Nw Hawthorne Ave Grants Pass OR 97526-1051 Ph: (541) 471-3455 | Lorna Byrne Middle School Sbhc 101 S Junction Ave Cave Junction OR 97523-9006 Ph: (541) 592-6978 |
| NPI Number | 1740428127 |
|---|---|
| Provider Enumeration Date | 01/23/2009 |
| Last Update Date | 10/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740428127 | NPI | - | NPPES |
| 127725 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 127725 (Oregon) | Primary |
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