| NPI | 1740812809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JOHN TILLEY Owner 503-840-0387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |