Healthcare Provider Details

I. General information

NPI: 1104276302
Provider Name (Legal Business Name): ALL HEART COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 SE 1ST ST
PENDLETON OR
97801-2204
US

IV. Provider business mailing address

114 SE 1ST ST
PENDLETON OR
97801-2204
US

V. Phone/Fax

Practice location:
  • Phone: 541-429-9000
  • Fax:
Mailing address:
  • Phone: 541-429-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE MEDRANO
Title or Position: PART OWNER/COUNSELOR
Credential: CADCII,CGACII,NCGCII
Phone: 154-142-9000