| NPI | 1114316551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE DAVID SEWITSKY Finance Manager 541-858-8170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |