| NPI | 1417221375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL V CARROLL Owner 503-399-0189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OR 508201) |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2012-02-23 |