| NPI | 1710173802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA S DEDOLPH Director/Therapist 503-325-2398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR C1489) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2007-09-21 |