| NPI | 1740420181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN LARSEN Director 541-386-1115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR MD20823) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2009-02-25 |