| NPI | 1235646266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAIL L HARBICKQ Owner 541-822-3603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2017-12-29 |