| NPI | 1639589344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE OSBORNE Counseling Services Coordinator 385-468-4519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 1558665026) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2014-05-02 |