| NPI | 1952940298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY CARL WILLIAMS Suds Counselor 503-789-2430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |