| NPI | 1043607526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD JACOBSON Executive Director 503-397-5211 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2022-03-25 |