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Mr. Thomas Wayne Stutzman
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Monmouth, Oregon
NPI 1376188896

Thomas Wayne Stutzman is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Monmouth, OR. Thomas Wayne Stutzman practices in Monmouth, OR. The NPI Number for Thomas Wayne Stutzman is 1376188896 and holds a License No. 527851 (Oregon).

The current practice location address for Thomas Wayne Stutzman is 168 Ackerman St E, Monmouth, OR and can be reached out via phone at 503-409-5804.

Location: 168 Ackerman St E, Monmouth, OR, 97361-2214
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376188896
Provider Name
Thomas Wayne Stutzman
Credential
Provider Entity Type
Individual
Gender
Male
Address
168 Ackerman St E, Monmouth, OR, 97361-2214
Phone Number
503-409-5804
Fax Number
Provider Enumeration Date
11/07/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
168 Ackerman St E
City
Monmouth
State
Oregon
Zip
97361-2214
Phone Number
503-409-5804
Fax Number
person
Provider Business Mailing Address Details
Address
168 Ackerman St E
City
Monmouth
State
Oregon
Zip
97361-2214
Phone Number
503-409-5804
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
527851 ()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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