Va Southern Oregon
NPI #1124198999 in White City, Oregon
Provider Information
- NPI Number
- 1124198999
- Entity Type
- Organization
- Organization Name
- Va Southern Oregon
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Nov 9, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 8495 CRATER LAKE HWY
- City
- White City
- State
- Oregon
- ZIP Code
- 97503-3011
- Phone
- (541) 826-2111
Authorized Official
- Name
- WOLFGANG LAURENCE AGOTTA
- Title
- DUAL-DIAGNOSIS THERAPIST
- Phone
- (541) 826-2111
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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