| NPI | 1013626233 |
|---|---|
| Doing Business As | OFFICE BASED ADDICTION TREATMENT (OBAT) |
| Entity Type | Organization |
| Authorized Contact | LESA WAGNER Credentialing Specialist 541-265-0445 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2023-04-03 |