Provider Demographics
NPI:1295122380
Name:REFUGE MUSIC THERAPY, LLC
Entity type:Organization
Organization Name:REFUGE MUSIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MUSIC THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:OAR
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:541-231-7239
Mailing Address - Street 1:PO BOX 50175
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-0971
Mailing Address - Country:US
Mailing Address - Phone:541-231-7239
Mailing Address - Fax:
Practice Address - Street 1:144 E 14TH AVE
Practice Address - Street 2:SUITE E
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3533
Practice Address - Country:US
Practice Address - Phone:541-231-7239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty