| NPI | 1730225236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CORBIN Program Manager 503-285-9871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR C1537) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |