| NPI | 1922243815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY S CAMERON Owner 503-320-4764 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2008-12-08 |