| Altoris Behavior Support Llc | |
|
3880 Se 8th Ave Ste 105 Portland OR 97202-3772 | |
| (503) 803-7335 | |
| Not Available |
| Full Name | Altoris Behavior Support Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3880 Se 8th Ave Ste 105, Portland, Oregon |
| Authorized Official Name and Position | Wesley Earl Carson (CHAIRMAN & CEO) |
| Authorized Official Contact | 5038037335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Altoris Behavior Support Llc 3880 Se 8th Ave Ste 105 Portland OR 97202-3772 Ph: (503) 803-7335 | Altoris Behavior Support Llc 3880 Se 8th Ave Ste 105 Portland OR 97202-3772 Ph: (503) 803-7335 |
| NPI Number | 1184247850 |
|---|---|
| Provider Enumeration Date | 05/28/2020 |
| Last Update Date | 05/28/2020 |
| Certification Date | 05/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184247850 | NPI | - | NPPES |
| 500718376 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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