| Bhd Gun Violence Impacted Families Behavioral Health Response Team | |
|
209 Sw 4th Ave Ste 520 Portland OR 97204-1825 | |
| (503) 988-8291 | |
| Not Available |
| Full Name | Bhd Gun Violence Impacted Families Behavioral Health Response Team |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 209 Sw 4th Ave Ste 520, Portland, Oregon |
| Authorized Official Name and Position | Alicia Thompson Rodriguez (ACCESS MANAGER/PROGRAM SPECIALIST) |
| Authorized Official Contact | 5035979405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhd Gun Violence Impacted Families Behavioral Health Response Team 619 Nw 6th Ave Portland OR 97209-3964 Ph: (503) 988-8291 | Bhd Gun Violence Impacted Families Behavioral Health Response Team 209 Sw 4th Ave Ste 520 Portland OR 97204-1825 Ph: (503) 988-8291 |
| NPI Number | 1013698497 |
|---|---|
| Provider Enumeration Date | 07/27/2023 |
| Last Update Date | 07/28/2023 |
| Certification Date | 07/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013698497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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