VA SOUTHERN OREGON is a substance abuse rehabilitation facility in White City, OR. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. VA SOUTHERN OREGON NPI is 1124198999. The provider is registered as an organization entity type.
The provider's business location address is:
8495 CRATER LAKE HWY
WHITE CITY, OR
ZIP 97503-011
Phone: (541) 826-2111
The provider's authorized official is Wolfgang Laurence Agotta .
The authorized official title is Dual-diagnosis Therapist and has the following contact phone number (541) 826-2111.
The CLIA number assigned to this NPI record is 38D0988128 - other with a certificate type of Certificate of Accreditation.
The enumeration date for this NPI number is 11/9/2006 and was last updated on 8/22/2020.