| NPI | 1235684739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE CATHERINE MELLOW Owner 541-490-2999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OR C4134) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WA LH60626167) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OR C4134) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WA LH 60626167) | |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |