| NPI | 1982197182 |
|---|---|
| Other Name | PHD |
| Entity Type | Organization |
| Authorized Contact | MELISSA KIM HOMAN Regional Director 541-720-4636 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: OR 700119) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-16 |