| NPI | 1265866305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY GREGG Superintendent 503-986-0361 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: OR 700035) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2013-08-26 |