| NPI | 1063990851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEDDI NEE A RN P 541-371-2511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2022-10-28 |