| NPI | 1255106696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZY VENZKE Senior Billing Manager 503-205-4362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2023-11-15 |