| NPI | 1346895984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY KETTERMANN President 971-270-0167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251B00000X Case Management |
| 251K00000X Public Health or Welfare | |
| 251V00000X Voluntary or Charitable | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-08-08 |