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General NPI Number Information
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NPI Number | 1932330008
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Entity Type | Organization
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Legal Business Name | OREGON MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 602 PLEASANT OAK DR
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City | OREGON
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State | WI
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Zip | 53575-3282
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Country | US
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Telephone | 608-835-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 602 PLEASANT OAK DR
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City | OREGON
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State | WI
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Zip | 53575-3282
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Country | US
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Telephone | 608-835-5050
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARY J SELLA
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Credential | LCSW
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Telephone | 608-835-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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