Healthcare Provider Details
I. General information
NPI: 1124178868
Provider Name (Legal Business Name): SYMMETRY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2007
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
348 W. ADAMS
BURNS OR
97720
US
IV. Provider business mailing address
348 W. ADAMS
BURNS OR
97720
US
V. Phone/Fax
- Phone: 541-573-8376
- Fax: 541-573-8378
- Phone: 541-573-8376
- Fax: 541-573-8378
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
CHRIS
SIEGNER
Title or Position: DIRECTOR/CHIEF EXECUTIVE OFFICER
Credential: LCSW
Phone: 541-573-8376