Provider Demographics
NPI:1942048822
Name:VOYAGE FAMILY THERAPY
Entity type:Organization
Organization Name:VOYAGE FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-708-9992
Mailing Address - Street 1:225 TIMBER RIDGE ST NE APT 209
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-7438
Mailing Address - Country:US
Mailing Address - Phone:702-708-9992
Mailing Address - Fax:503-376-6225
Practice Address - Street 1:225 TIMBER RIDGE ST NE APT 209
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-7438
Practice Address - Country:US
Practice Address - Phone:702-708-9992
Practice Address - Fax:503-376-6225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty