| NPI | 1356233175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETISHA CORZINE Provider 541-591-7889 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-07-16 |
| Last Update Date | 2025-07-16 |