| NPI | 1629322847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JAMES SMITH Coder/Billing Coordinator 541-373-8116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251K00000X Public Health or Welfare | |
| 251S00000X Community/Behavioral Health | |
| 261QA0005X Clinic/Center, Ambulatory Family Planning Facility | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2022-07-21 |