NPI | 1427680057 |
---|---|
Doing Business As | MEDFORD TREATMENT CENTER |
Entity Type | Organization |
Authorized Contact | DANA JORGENSEN Authorized Official 541-322-1794 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
Enumeration Date | 2020-02-11 |
Last Update Date | 2021-09-16 |