| NPI | 1851757454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMA J BURTON Member Manager 541-601-6163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |