| NPI | 1497235576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CULLISON Director 971-344-9674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR DZ1279) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |