| NPI | 1316680085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESSI D PEREZ Credentialing 541-244-4109 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-04-19 |