| NPI | 1174910095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ISAMU MANOCK Founder President 503-881-0513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR T0808) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |