| NPI | 1568858363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W SANT Administrator 503-260-0969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR L6297) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2015-04-08 |