| NPI | 1992883631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MAHLER Executive Director 503-722-4470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2025-09-11 |