Provider First Line Business Practice Location Address: 
7525 WESTGATE BLDG #2
    Provider Second Line Business Practice Location Address: 
PENDLETON CREEK CRISIS STABILIZATION UNIT
    Provider Business Practice Location Address City Name: 
PENDLETON
    Provider Business Practice Location Address State Name: 
OR
    Provider Business Practice Location Address Postal Code: 
97801
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
541-240-8030
    Provider Business Practice Location Address Fax Number: 
541-429-8737
    Provider Enumeration Date: 
03/08/2016