Pacific Crest Trail Detox LLC
NPI #1043760838 in Milwaukie, Oregon
Provider Information
- NPI Number
- 1043760838
- Entity Type
- Organization
- Organization Name
- Pacific Crest Trail Detox LLC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Oct 5, 2016
- Last Updated
- Oct 5, 2016
Practice Location
Authorized Official
- Name
- BENJAMIN RANDOLPH, MS, CADCIII
- Title
- CEO
- Phone
- (503) 901-1836
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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