Va Southern Oregon

NPI 1124198999 - Substance Abuse Rehabilitation Facility - 324500000X

NPI Details
NPI 1124198999
Enumeration Date 11/09/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name WOLFGANG LAURENCE WOLFGANG
Position DUAL-DIAGNOSIS THERAPIST
Phone (541) 826-2111
Fax
Practice Location
8495 CRATER LAKE HWY
WHITE CITY OR, 97503-3011, US
Phone (541) 826-2111
Fax
Business Location
839 N MAIN ST
ASHLAND OR, 97520-1713, US
Phone (541) 261-8349
Fax
Toxanomy
Taxonomy Code 324500000X
License State
License Number
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According to our database, Va Southern Oregon NPI is 1124198999, taxonomy code is 324500000X Va Southern Oregon physically located at 8495 Crater Lake Hwy, White City OR, 97503-3011. NPI Number 1033115704 has the healthcare provider type.

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1124198999 NPI number is provided on an as is basis without warranty of any kind. 1124198999 is maintained by the National Plan & Provider Enumeration System. The contents of Va Southern Oregon are for informational purposes only.