| NPI | 1417498395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA RAE DRUM Owner 503-926-3589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR R4463) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |