| NPI | 1477906048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSAH ANN GREEN Owner 503-728-8546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR 122027899) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |