| NPI | 1699261990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO CLIFTON LONG-DREW Owner/Operator 541-561-8127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R4884) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |