| NPI | 1538320528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY CHURCH Business Manager 541-396-3173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |