| NPI | 1922552363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA RENE TUCKER CEO 503-317-4240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR L4517) |
| Enumeration Date | 2016-08-13 |
| Last Update Date | 2016-08-13 |