| NPI | 1740543297 |
|---|---|
| Doing Business As | HER PLACE RESIDENTIAL HOME |
| Entity Type | Organization |
| Authorized Contact | MAI CAO Billing Supervisor 503-361-2648 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |