| NPI | 1235474842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE BALCOM Founding Director 541-469-7611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 094003275RN) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2012-12-07 |