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General NPI Number Information
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NPI Number | 1750402913
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Entity Type | Organization
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Legal Business Name | DOUGLAS COUNTY CHILDRENS CENTER, INC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1939 NE DIAMOND LAKE BLVD
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City | ROSEBURG
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State | OR
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Zip | 97470-3573
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Country | US
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Telephone | 541-957-5646
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Fax | 541-957-0191
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Provider Business Mailing Address
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Address Line | 1939 NE DIAMOND LAKE BLVD
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City | ROSEBURG
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State | OR
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Zip | 97470-3573
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Country | US
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Telephone | 541-957-5646
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Fax | 541-957-0191
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Authorized Official
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Title or Position | BILLING/CREDENTIALING DEPT
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Name | RHONDA FOSTER
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Credential |
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Telephone | 541-957-5646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 00819782-7
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License Number State | OR
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