| NPI | 1679957708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA LEE Single Member LLC 541-679-0366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR 200550033NP) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-11-13 |