| NPI | 1174738686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED T MACKLIN Director 503-655-1029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 03040) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2008-07-07 |