| NPI | 1730167982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PUMP Executive Director 503-591-9280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2013-04-11 |