| NPI | 1134834567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JINXI CADDEL Owner 541-329-9470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2024-04-13 |