| NPI | 1215463518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER GREENE Owner 971-724-7393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR L4691) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2017-05-04 |