| NPI | 1851376669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA MAHONEY Owner Program Director 541-276-1022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OR CADCII 001147) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OR NCACI013814) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-08-22 |