| NPI | 1013567106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRITZ JOHN BACHMAN Director 541-506-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2019-09-19 |