| NPI | 1407388812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMOLOLA A ELLIOTT Therapist 971-212-3146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR L7113) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |