| NPI | 1477250603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH L PHILLIPS Director Of Billing 541-492-0134 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2025-09-11 |