| NPI | 1679927644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY JONES Owner 971-227-1465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR 201393706NP) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2022-03-11 |