| NPI | 1306523568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI PETRA DAVISSON Licensed Professional Counselor 503-929-7750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2024-04-08 |