| NPI | 1073003521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBETTE R WOODALL Owner 971-240-0498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-05-10 |