| NPI | 1861927089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE RHEAULT Mental Health Therapist 541-499-1088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR C1655) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |