| NPI | 1629470257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KELLEY Fiscal Manager 503-535-3882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR 1041C0700X) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2014-09-26 |