| NPI | 1326597519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BRAKE Co Owner 541-670-2264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C3280) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-28 |