| NPI | 1477708113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE EIDSON CFO 541-779-2393 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2013-05-02 |