| NPI | 1174372999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD JACOBSON Executive Director 503-438-2201 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-14 |