| NPI | 1629168166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNA M MEYER Interim Director 541-679-6129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: OR CERTIFICATE APPROVAL) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: OR CERTIFCATE OF APPROV) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |