NPI 1750571345

Jefferson Behavioral Health

Organisation Exclusive Provider Organization Grants Pass, OR

Practice location

Address: 550 NE E St, Grants Pass, OR 97526-2326
Phone: (541) 955-9565
Fax: (541) 955-8290

Authorised official

Name: Bob Nikkel
Title: Executive Director
Phone: (541) 955-9565

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 119488 (OR)

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Registry record

NPI: 1750571345
Entity type: Organization
NPI issued: 30 Jul 2007
Record last updated: 11 Aug 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.