| NPI | 1235819970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA STIDHEM Director Of Outpatient Services 541-505-9190 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2024-12-26 |