| NPI | 1992238091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH BRADY BRAITHWAITE COO/CFO 503-749-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2019-06-20 |