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General NPI Number Information
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NPI Number | 1609739689
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Entity Type | Organization
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Legal Business Name | MAXS MISSION
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 3815 S 6TH ST
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City | KLAMATH FALLS
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State | OR
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Zip | 97603-4759
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Country | US
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Telephone | 541-499-8012
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 S 6TH ST
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City | KLAMATH FALLS
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State | OR
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Zip | 97603-4759
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Country | US
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Telephone | 541-499-8012
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DAVID PINSKY
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Credential |
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Telephone | 541-840-9314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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