| NPI | 1265025050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN DINGELDEIN Psychiatric Nurse Practitioner 541-990-2613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-04-05 |