| NPI | 1356906788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERMAINE CHRISTOPHER MASON Owner 503-206-8856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2023-11-01 |