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NPI Code Detail

MEDICARE: HELEN KLEINT CRM

MEDICARE: HELEN KLEINT CRM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0800XRecovery Care Clinic/CenterOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
121-CRM-672OTHERORMHACBO

General Provider Information

NPI Number : 1376295675
Entity Type Code : Individual
Provider Name (Legal Business Name) : HELEN KLEINT CRM
Provider Business Mailing Address
First Line : 30965 SW LARSON RD
Second Line :
City : LEBANON
State : OR
Zip : 97355-9272
Country : US
Telephone Number : 541-570-8234
Fax Number :
Provider Business Practice Location Address
First Line : 231 LYON ST SE
Second Line :
City : ALBANY
State : OR
Zip : 97321-2707
Country : US
Telephone Number : 541-791-3411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2022
Last Update Date : 01/19/2022

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Directions to “ HELEN KLEINT CRM” Practice Location

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