| NPI | 1114472552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE E ROGERS Owner 541-484-4881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR C0810) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-08-15 |