| NPI | 1487241436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA REDEAU Owner 503-998-5613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2021-01-07 |