| NPI | 1265315709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO JONES CEO 503-901-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-09-03 |