| NPI | 1093696262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN NEVADA MARTINEZ-WARREN Director & Mental Health Therapist 541-600-9760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Enumeration Date | 2025-09-11 |
| Last Update Date | 2025-10-26 |