| NPI | 1972139947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN T RYAN Counselor / Practioneer 541-296-6114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2024-09-18 |