Healthcare Provider Details

I. General information

NPI: 1770398174
Provider Name (Legal Business Name): REIGN WHOLE HEALTH & HEALING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 S CENTRAL AVE STE 110
MEDFORD OR
97501-7274
US

IV. Provider business mailing address

45 E STEWART AVE # 1093
MEDFORD OR
97501-7924
US

V. Phone/Fax

Practice location:
  • Phone: 541-200-5804
  • Fax:
Mailing address:
  • Phone: 541-200-5804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VALENCIA MARIE ROLLINS
Title or Position: OWNER/CEO
Credential:
Phone: 541-200-5323