| NPI | 1881358901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SLAD F THACKERAY Director/Owner 503-910-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2021-11-05 |