IndividualActive
Sofia De Sousa
NPI 1649129347 · Emotionally Disturbed Childrens' Residential Treatment Facility · Medford, OR
Provider details
- NPI number
- 1649129347
- Entity type
- Individual
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
510 W 11th St
Medford, OR 97501-3555
Phone: (541) 613-0084
Approximate (ZIP-level) locationGet directions
Mailing address
2981 State St Apt 71
Medford, OR 97504-8451
Registry dates
- Enumerated
- 2026-01-26
- Last updated
- 2026-01-26
- Certified
- 2026-01-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.