| NPI | 1518201151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE DAVID SEWITSKY Finance Manager 541-858-8170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: OR 07863) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OR 07863) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |