| NPI | 1104027341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JON NUNNERY Cats I 541-258-2154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |