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1154980308
JESSE BENJAMIN FLACK
ALBANY, OR
NPI
1154980308
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 21-04-10112)
Enumeration Date
2019-06-11
Last Update Date
2021-10-04
Business Address
JESSE BENJAMIN FLACK CADC-I
1050 PRICE RD SE
ALBANY, OR 97322-7314
Phone number: 541-928-9681
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Mailing Address
JESSE BENJAMIN FLACK CADC-I
PO BOX 8549
COBURG, OR 97408-1313
Phone number: 541-687-1110
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