| Sam Recovery House Llc | |
|
16132 Ne Glisan St Portland OR 97230-5439 | |
| (971) 386-7444 | |
| Not Available |
| Full Name | Sam Recovery House Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 16132 Ne Glisan St, Portland, Oregon |
| Authorized Official Name and Position | Fuad Abdinor Mohamed (CEO) |
| Authorized Official Contact | 9713867444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sam Recovery House Llc 16132 Ne Glisan St Portland OR 97230-5439 Ph: (971) 386-7444 | Sam Recovery House Llc 16132 Ne Glisan St Portland OR 97230-5439 Ph: (971) 386-7444 |
| NPI Number | 1407686512 |
|---|---|
| Provider Enumeration Date | 08/05/2024 |
| Last Update Date | 08/05/2024 |
| Certification Date | 08/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407686512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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