NPI | 1740844984 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT JOHN TILLEY President 503-840-0387 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
Enumeration Date | 2019-04-23 |
Last Update Date | 2024-02-28 |