NPI | 1083154637 |
---|---|
Entity Type | Organization |
Authorized Contact | RYANN MISHELL MOORE Manager/Owner 503-706-8413 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR 5355) |
Enumeration Date | 2017-03-01 |
Last Update Date | 2017-03-01 |