| NPI | 1144979063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN WILTROUT Executive Administrator 541-622-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2023-10-20 |