| Intentional Living Programs, LLC | |
|
405 W 4th St The Dalles OR 97058-1305 | |
| (541) 298-8227 | |
| (541) 769-0153 |
| Full Name | Intentional Living Programs, LLC |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 405 W 4th St, The Dalles, Oregon |
| Authorized Official Name and Position | Sandra Bartholomew (OWNER) |
| Authorized Official Contact | 5412988227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intentional Living Programs, LLC 405 W 4th St The Dalles OR 97058-1305 Ph: (541) 298-8227 | Intentional Living Programs, LLC 405 W 4th St The Dalles OR 97058-1305 Ph: (541) 298-8227 |
| NPI Number | 1013550441 |
|---|---|
| Provider Enumeration Date | 10/17/2019 |
| Last Update Date | 10/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013550441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (NU) | Primary |
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