| NPI | 1023243508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNAN MAYS Administrater 503-665-5193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OR 320800000X) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2010-02-18 |