| NPI | 1023980539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA DAWN VEST Program Administrator 971-710-5408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-09-23 |
| Last Update Date | 2025-09-23 |