| NPI | 1326433012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD VARNUM COO 541-485-2711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2017-02-15 |