| NPI | 1679597108 |
|---|---|
| Doing Business As | LEGACY GOOD SAMARITAN PROVIDERS |
| Entity Type | Organization |
| Authorized Contact | SARAH JENSEN Interim CFO 503-415-5145 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2018-02-27 |