| NPI | 1083010094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI MCBRIDE Operations Manager 503-906-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2021-08-19 |