| NPI | 1295038081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY VANDENBOGAARD Owner/Primary Therapist 541-704-0762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OR 064) |
| Additional Taxonomies | 251B00000X Case Management (Licence: OR 064) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2010-12-16 |