Blue Diamond Estates

NPI #1962090951 in Bandon, Oregon

Provider Information

NPI Number: 1962090951
Entity Type: Organization
Organization Name: Blue Diamond Estates
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jan 5, 2021
Last Updated: Jan 5, 2021

Practice Location

Address: 87326 MCTIMMONS LN
City: Bandon
State: Oregon
ZIP Code: 97411-8285
Phone: (541) 217-4006

Authorized Official

Name: MARY JOHNSON
Title: QMHA
Phone: (541) 751-5040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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