| NPI | 1417411505 |
|---|---|
| Doing Business As | KOD @ KBBH |
| Entity Type | Organization |
| Authorized Contact | JEANA MASTERS Cpes 541-880-2011 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2020-08-06 |