| NPI | 1164235271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON E. BOLLES Clinical Director 541-840-5922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-01-31 |