Individual provider · Type 1 NPI
Sofia Antonia De Sousa
Emotionally Disturbed Childrens' Residential Treatment Facility · Medford, OR
Practice location
510 W 11th St
Medford, OR 97501-3555
Mailing address
2981 State St Apt 71
Medford, OR 97504-8451
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | None listed |
Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
2 other providers at this address
About NPI 1649129347
Sofia Antonia De Sousa's National Provider Identifier is 1649129347, issued on Jan 26, 2026. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Medford, OR. The record was last updated on Jan 26, 2026.