| NPI | 1922582493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI ANN HECOX Medical Director 541-200-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2022-11-17 |