Pioneer Guest Home

NPI #1982859393 in Enterprise, Oregon

Provider Information

NPI Number: 1982859393
Entity Type: Organization
Organization Name: Pioneer Guest Home
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Nov 26, 2008
Last Updated: Nov 26, 2008

Practice Location

Address: 101 E MAIN ST
Address 2: BOX 326
City: Enterprise
State: Oregon
ZIP Code: 97828-1381
Phone: (541) 426-4222

Authorized Official

Name: MR. RANDALL PERRY RODDEY, MSGT/ USMC RETIRED
Title: LICENSED ADMINISTRATOR
Phone: (541) 426-4222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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