| NPI | 1760127054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMATA ADEBAWO Manager 971-220-1870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 261QC1500X Clinic/Center Community Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2022-05-01 |
| Last Update Date | 2022-05-01 |