| NPI | 1073479804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRUME A MEKONNEN Authorized Official 503-422-8583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-12-24 |
| Last Update Date | 2025-12-24 |