Southern Oregon Neuropsychological Clinic Llc

LBN: Southern Oregon Neuropsychological Clinic Llc
Southern Oregon Neuropsychological Clinic Llc is an health care organization with primary practice located at 837 Alder Creek Dr , Medford OR 97504. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is the primary health care specialty. Southern Oregon Neuropsychological Clinic Llc can be contacted via phone (541) 608-3878, or through Villanueva, Michael R via phone (541) 608-3878.

Contact Information

Primary practice address
837 Alder Creek Dr Medford OR 97504
Phone: (541) 608-3878
Fax: (541) 608-3880
Website:
Map and Directions
Authorized official contact:
Name: Villanueva, Michael R PSYD
Phone: (541) 608-3878

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X

Profile Details

NPI number 1588726939
LBN Legal business name Southern Oregon Neuropsychological Clinic Llc
DBA Doing business as
Authorized official Villanueva, Michael R PSYD
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2006
Last updated Jul 16th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588726939 NPPES
Oregon MEDICAID 042601

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