NPI | 1316680085 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELLE M LENTZ Credentialing 541-244-4152 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2022-04-19 |
Last Update Date | 2025-04-09 |