| NPI | 1912322074 |
|---|---|
| Other Name | CENTENNIAL SCHOOL BASE |
| Entity Type | Organization |
| Authorized Contact | DERRICK MOTEN Interim Business Services Director 503-988-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2024-05-18 |