| NPI | 1871341784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS CRAPSER Clinical Director 971-442-0044 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2024-05-07 |