| NPI | 1083751663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMERA COOKE Residential Counselor 503-255-3198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 372600000X Adult Companion |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |