TRILLIUM FAMILY SERVICE (NPI# 1538570551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538570551 |
| Entity Type | Organization |
| Organization Name | TRILLIUM FAMILY SERVICE |
| Practice Address |
3415 Se Powell Blvd Portland OR 97202-3371 |
| Practice Telephone | 5032349591 |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |
| Authorized Official Name | MARISELA JOHNSON (SKILL TRAINER) |
| Authorized Official Telephone | 5032439591 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275734485 | Trillium Family Service | Residential Treatment Facility, Emotionally Disturbed Children | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2007-05-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | TRILLIUM FAMILY SERVICES FOUNDATION, INC. | 3415 Se Powell Blvd, Portland, OR 97202 |
| Oregon Corporations, Companies and Business Names | TRILLIUM FAMILY SERVICES, INC. | 3415 Se Powell Blvd, Portland, OR 97202 |
| Street Address |
3415 SE POWELL BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97202-3371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568484103 | Kelley S. Fellman | Psychiatry & Neurology | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2006-07-24 |
| 1639778715 | Nathanial Bridger Caldwell | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3396 | 2020-10-20 |
| 1104425537 | Jordan Stead | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-16 |
| 1790383560 | Patricia Sullivan | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-14 |
| 1336747104 | Kevin Xiong | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-14 |
| 1609474378 | Gabriella Francolla | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-14 |
| 1447858121 | Caitlynn Smith | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-14 |
| 1689281321 | Ava Menchu | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-09-27 |
| 1255948014 | Garrett Key | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-09-25 |
| 1578170676 | Tenzin Namdol | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-09-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143442 | Carewell LLC | Counselor | Portland River Park Center, 205 Se Spokane St Suite 358, Portland, OR 97202 | 2020-01-24 |
| 1588226765 | Melissa Lynn Hartley | Counselor | 1235 Se Division St. Suite 103, Portland, OR 97202 | 2019-07-08 |
| 1275192999 | Kimberly Rae Kilgore | Counselor | 5509 Se 22nd St #3a, Portland, OR 97202 | 2019-06-06 |
| 1639736069 | Kyra Steinhauer | Social Worker | 3145 Se Powell Blvd, Portland, OR 97202 | 2019-05-21 |
| 1134644321 | Bridgette Hennigsen | Social Worker | 3810 Se 11th Ave, Portland, OR 97202 | 2017-08-08 |
| 1558895789 | Lenore Cangeloso | Acupuncturist | 1235 Se Division Street, Suie 117, Portland, OR 97202 | 2017-04-14 |
| 1376099093 | Anna Christine Leclerc | Contractor | 2024 Se Clinton Street, Zenana Spa and Wellness Center, Portland, OR 97202 | 2016-09-01 |
| 1144684663 | Catholic Charities | Case Management | 2740 Se Powell Blvd., Portland, OR 97202 | 2016-04-11 |
| 1881082097 | Zoomcare Dental, P.C. | Dentist | 3130 Se Division Street, Building 2, Portland, OR 97202 | 2014-12-23 |
| 1124424700 | Jessica Nash | Counselor | 6411 Se 17th Ave, Portland, OR 97202 | 2014-11-10 |
| Find all providers in zip 97202 | ||||
| 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 |
| 1306288071 | The Inn, Home for Boys | Residential Treatment Facility, Emotionally Disturbed Children | 8940 Se 72nd Ave, Portland, OR 97206-9417 | 2013-07-23 |
| 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 |
| 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 |
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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.