| NPI | 1790166817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE LEDFORD Owner 541-690-8710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR T1043) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |