| NPI | 1356194732 |
|---|---|
| Former Legal Business Name | STONESOUP HRC |
| Entity Type | Organization |
| Authorized Contact | MATTHEW PETERSON Executive Director 541-231-5597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-04-11 |