| NPI | 1609695477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR WATTE Administrator 503-989-9180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 177F00000X Lodging |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2024-10-08 |