NPI | 1750127429 |
---|---|
Entity Type | Organization |
Authorized Contact | EDMOND DESHAWN WILLIAMS Clinical Supervisor 503-334-9955 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2024-07-02 |
Last Update Date | 2024-07-02 |