| NPI | 1316203508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY DEAN GONZALES Miliue Counselor 503-571-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: OR 284300000X) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2021-06-01 |