| NPI | 1184089401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE C MATTEUCCI Counselor 971-732-6614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR C3379) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |