| NPI | 1710445218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMISHA K WILSON Clinical Director 971-279-7439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2020-04-15 |