| NPI | 1003789066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GOBENA SEIFU Administrator/Director 971-261-8518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2025-10-04 |