| NPI | 1881010502 |
|---|---|
| Former Legal Business Name | CLEAN ADVENTURES OF OREGON |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN RANDOLPH Owner 503-901-1836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2015-04-28 |