| NPI | 1861967648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MONET WATSON Chief Operations Officer 541-492-4550 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2022-04-12 |