| NPI | 1316471550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANAE OLSON Executive Director 503-550-4433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN cc01030) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MN cc00245) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2017-04-14 |