| NPI | 1255584538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC DAVIS Program Director 503-370-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR CO492) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2008-10-30 |