| NPI | 1629270780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE D. CREGER Clerical Specialist 541-276-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: OR 12718785) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2007-12-13 |