| NPI | 1700477619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRENTICE GEARY Chief Operating Officer 971-378-0367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2024-07-31 |