| NPI | 1215732813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER PATRICK JOHNSON Administrative Assistant 541-215-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |