| NPI | 1902201361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY LIEBE Program Manager 503-369-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2015-04-03 |