| NPI | 1104591122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRETT FLESH Owner 541-633-9824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2021-08-11 |