Individual ProviderJuan AvilaCounselorBehavioral Health & Social Service ProvidersPractice Address1021 W 9th St, The Dalles, OR 97058-1007(541) 298-1920(541) 858-8170PECOS EnrollmentBased on the most recent information from CMS, provider Juan Avila does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1093283699Provider TypeIndividualFull NameAvila, JuanGenderMaleSole ProprietorNoEnumeration Date11/13/2018Last Updated11/13/2018Contact InformationPractice LocationPractice Address1021 W 9th St, The Dalles, OR 97058-1007Phone(541) 298-1920Fax(541) 298-1917Mailing LocationMailing Address3587 Heathrow Way, Medford, OR 97504-4004Phone(541) 858-8170Fax(541) 858-8167Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer