THE INN, HOME FOR BOYS (NPI# 1306288071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306288071 |
Entity Type | Organization |
Organization Name | THE INN, HOME FOR BOYS |
Other Organization Name | THE INN |
Practice Address |
8940 Se 72nd Ave Portland OR 97206-9417 |
Mailing Address |
5605 E Burnside St Portland OR 97215-1499 |
Practice Telephone | 5037776317 |
Mailing Telephone | 5032348757 |
Mailing Fax Number | 5032348758 |
Enumeration Date | 2013-07-23 |
Last Update Date | 2013-07-23 |
Authorized Official Name | THOMAS J MITCHELL (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 5032348757 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | OR | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
The Inn | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | THE INN, HOME FOR BOYS | 8940 Se 72nd Ave, Portland, OR 97206 |
Street Address |
8940 SE 72ND AVE |
City | PORTLAND |
State | OR |
Zip Code | 97206-9417 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033623368 | Thomas Mccormick | Social Worker | 8940 Se 72nd Ave, Portland, OR 97206-9417 | 2017-11-22 |
1235643560 | Kalena Karp | Social Worker | 8940 Se 72nd Ave, Portland, OR 97206-9417 | 2017-11-22 |
1740726074 | Mike Tassini | Social Worker | 8940 Se 72nd Ave, Portland, OR 97206-9417 | 2017-01-10 |
1821534132 | Natalie Wood | Social Worker | 8940 Se 72nd Ave, Portland, OR 97206-9417 | 2017-01-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346852365 | Amanda Kristine Fredrickson | Dietitian, Registered | 3611 Se 64th Ave., Portland, OR 97206 | 2020-08-20 |
1578108940 | Amy Groulx | Technician | 5506 Se Mitchell St, Portland, OR 97206 | 2019-11-08 |
1477061265 | Lisa Marie Matejka | Naturopath | 5235 Se Lambert St, Apt. #b6, Portland, OR 97206 | 2018-01-16 |
1639625205 | Mollie Kathleen Pence | Registered Nurse | 2415 43rd Ave, Suite 100, Cascadia Behavioral Healthcare Urgent Walkin Clinic, Portland, OR 97206 | 2016-09-01 |
1457709164 | Lauren Murdoch | Massage Therapist | 4629 Southeast Woodstock Boulevard, Portland, OR 97206 | 2016-06-03 |
1962897785 | Meigra Simon LLC | Mechanotherapist | 6842 Se Henry St, Portland, OR 97206 | 2015-03-30 |
1891186508 | Teresa Leckron-myers | Case Manager/Care Coordinator | 7916 Se Foster Rd, Portland, OR 97206 | 2015-02-17 |
1831597590 | Boey Yean Lim | Acupuncturist | 4629 Se Woodstock Blvd, Portland, OR 97206 | 2014-12-12 |
1295082329 | Chase Heywood Price | Acupuncturist | 5425 Se Raymond Street, Portland, OR 97206 | 2012-08-08 |
1154678423 | Annelise Sevastiana Schnase | Counselor | 4311 Se Woodstock Blvd, Portland, OR 97206 | 2012-08-06 |
Find all providers in zip 97206 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154758266 | Youth Guidance Association | Residential Treatment Facility, Emotionally Disturbed Children | 2730 Ne Flanders St, Portland, OR 97232-3160 | 2013-10-03 |
1669666061 | Thelissa D Casley | Residential Treatment Facility, Emotionally Disturbed Children | 4818 Ne 101st Ave, Portland, OR 97220-3319 | 2007-08-29 |
1336795905 | Amy North | Residential Treatment Facility, Emotionally Disturbed Children | 11035 Ne Sandy Blvd, Portland, OR 97220-2553 | 2019-08-09 |
1710439740 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2016-10-25 |
1538570551 | Trillium Family Service | Residential Treatment Facility, Emotionally Disturbed Children | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2014-05-13 |
1619395530 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2014-03-29 |
1154686632 | Parry Center for Children | Residential Treatment Facility, Emotionally Disturbed Children | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2012-07-10 |
1720344450 | Morrison Child & Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 9911 Se Mount Scott Blvd, Portland, OR 97266-6302 | 2012-04-06 |
1760766349 | Jennifer Garcia | Residential Treatment Facility, Emotionally Disturbed Children | 9911 Se Mount Scott Blvd, Portland, OR 97266-6302 | 2011-09-30 |
1679800197 | Albertina Kerr Centers | Residential Treatment Facility, Emotionally Disturbed Children | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2009-11-04 |
Find all providers in PORTLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.