| NPI | 1447643556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE TIERNY Clinical Director 503-226-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR 130906) |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-03-13 |