| NPI | 1922559764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER SHYBUT Milieu Counselor 503-652-2880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2021-06-01 |