| NPI | 1578864641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEROY JACKSON Health General Manager 541-882-1487 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |