Provider Demographics
NPI:1215017751
Name:PACIFIC CENTER FOR CHILDREN AND FAMILIES INC
Entity Type:Organization
Organization Name:PACIFIC CENTER FOR CHILDREN AND FAMILIES INC
Other - Org Name:PACIFIC CHILD CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIR BOARD OF DIRECTORS
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-267-1332
Mailing Address - Street 1:PO BOX 987
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459
Mailing Address - Country:US
Mailing Address - Phone:541-756-2516
Mailing Address - Fax:541-756-2516
Practice Address - Street 1:2345 MARION STREET
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459
Practice Address - Country:US
Practice Address - Phone:541-756-2516
Practice Address - Fax:541-756-2516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
Not Answered261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health