| NPI | 1699033365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN GATES Owner 541-412-9141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR L4678) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |