| NPI | 1437510922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN R. SHELTON Medical Director 503-378-5530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: OR 80045964) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-03-11 |