| NPI | 1174487813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWIT BERISSO Executive Director 971-393-6460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2025-12-15 |
| Last Update Date | 2025-12-15 |