| NPI | 1700619533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YARED DARCHA Manager 971-762-2087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2025-10-14 |