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1535 N Williams Ave Portland OR 97227-1885 | |
(503) 238-2067 | |
(503) 238-2004 |
Full Name | |
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Speciality | Substance Abuse Rehabilitation Facility |
Location | 1535 N Williams Ave, Portland, Oregon |
Authorized Official Name and Position | Andrew Mendenhall (PRESIDENT & CEO) |
Authorized Official Contact | 5032941681 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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232 Nw 6th Ave Attn: Bbis Credentialing Portland OR 97209-3609 Ph: (503) 294-1681 | 1535 N Williams Ave Portland OR 97227-1885 Ph: (503) 238-2067 |
NPI Number | 1609084904 |
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Provider Enumeration Date | 05/18/2007 |
Last Update Date | 03/06/2023 |
Identifier | Type | State | Issuer |
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1609084904 | NPI | - | NPPES |
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