| NPI | 1003327925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN POPPERT Owner 541-668-6891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2021-07-27 |