| NPI | 1730602194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRYSTAL KAY JOHNSON Owner/Manager/Clinician 541-447-6959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2022-07-21 |