| NPI | 1083750798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE REYNOLDS Counselor 503-867-4270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: OR 171MOOOOOX) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |