| NPI | 1437227535 |
|---|---|
| Other Name | WAVERLY CHILDREN'S HOME |
| Entity Type | Organization |
| Authorized Contact | SUZY VENZKE Billing Manager 503-205-4362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2014-03-26 |