| NPI | 1548307747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA R JONES Conusler 2 503-402-8116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OR 101ym0800x) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |