| NPI | 1124198999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WOLFGANG LAURENCE AGOTTA Dual Diagnosis Therapist 541-826-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |