| NPI | 1194150326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P GOFORTH Executive Director 503-857-0394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2016-12-02 |