| NPI | 1467885145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN GOLDEN Director 541-851-3856 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2013-08-16 |