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General NPI Number Information
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NPI Number | 1740582139
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Entity Type | Organization
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Legal Business Name | PREGNANCY ALTERNATIVES CENTER
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 136 W VINE ST
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City | LEBANON
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State | OR
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Zip | 97355-3345
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Country | US
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Telephone | 541-258-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 136 W VINE ST
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City | LEBANON
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State | OR
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Zip | 97355-3345
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Country | US
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Telephone | 541-258-3500
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. DEBBIE TRACY
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Credential |
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Telephone | 541-258-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 176332-80
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 17633280
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License Number State | OR
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