| NPI | 1861034951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIESL FARNSWORTH Owner 541-388-1261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2021-05-07 |