| NPI | 1619435617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAWNDA QUANIECE JONES Owner/Provider 503-490-5580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2019-03-08 |