| NPI | 1821852526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL LARA Addiction Counselor/Co Owner 541-429-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2024-02-13 |