| NPI | 1093474132 |
|---|---|
| Other Name | NOT APPLICABLE |
| Entity Type | Organization |
| Authorized Contact | TARA RAYBURN Founder & Director 971-645-0148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2021-12-16 |