| NPI | 1912390956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TIERNEY Clinic D Irector 503-226-2203 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2015-03-16 |