Life's Intention Back to Basics Inc.

NPI #1962103176 in Pendleton, Oregon

Provider Information

NPI Number: 1962103176
Entity Type: Organization
Organization Name: Life's Intention Back to Basics Inc.
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Mar 14, 2023
Last Updated: Mar 14, 2023

Practice Location

Address: 920 SW FRAZER AVE STE 212
City: Pendleton
State: Oregon
ZIP Code: 97801-2802
Phone: (541) 969-1941

Authorized Official

Name: AMY MADRIGAL-BATES, LPCA, CADC II, QMHP
Title: OWNER
Phone: (541) 969-1941

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X
Substance Abuse Rehabilitation Facility	324500000X
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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