| NPI | 1750912184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA DUFF Billing Manager 971-202-7752 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2025-07-22 |