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General NPI Number Information
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NPI Number | 1881401735
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Entity Type | Organization
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Legal Business Name | FAMILY CONNECTS OREGON
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 182 SW ACADEMY ST
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City | DALLAS
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State | OR
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Zip | 97338-1996
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Country | US
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Telephone | 503-623-8175
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Fax | 503-831-3499
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Provider Business Mailing Address
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Address Line | 182 SW ACADEMY ST
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City | DALLAS
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State | OR
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Zip | 97338-1996
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Country | US
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Telephone | 503-623-9289
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Fax | 503-623-2731
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Authorized Official
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Title or Position | HEALTH SERVICES DIRECTOR
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Name | DR. NOELLE K CARROLL
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Credential | PSY.D
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Telephone | 503-623-9289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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