| NPI | 1497906721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM CHARLES FOULKE President 503-422-3253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OR 08004508N6) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2008-10-06 |