SOBER LIVING OREGON TREATMENT CENTER (NPI# 1992204697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992204697 |
Entity Type | Organization |
Organization Name | SOBER LIVING OREGON TREATMENT CENTER |
Practice Address |
10209 Se Division Portland OR 97266 |
Mailing Address |
10209 Se Division St Bldg D Portland OR 97266-1372 |
Practice Telephone | 5037018397 |
Enumeration Date | 2018-02-08 |
Last Update Date | 2018-02-08 |
Authorized Official Name | GERALD TODD FLYNN (CLINICAL DIRECTOR) |
Authorized Official Telephone | 5038971916 |
Authorized Official Credential | MA |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
OR | Ambulatory Health Care Facilities |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | SOBER LIVING OREGON TREATMENT CENTER LLC | 9979 Se Old Town Ct, Happy Valley, OR 97086 |
Street Address |
10209 SE DIVISION |
City | PORTLAND |
State | OR |
Zip Code | 97266 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528545969 | Willamette Pharmacy | Pharmacy | 10209 Se Division Build B Ste 100, Portland, OR 97266 | 2018-07-27 |
1699204024 | Malori Christine Butler | Registered Nurse | 7335 Se 85th Ave., Portland, OR 97266 | 2017-06-08 |
1487028882 | Emil Kunkel | Naturopath | 6318 Se 87th Ave, Portland, OR 97266 | 2015-11-23 |
1194195313 | Cory Hall-martin | Counselor | 10011 Se Division St #305, Portland, OR 97266 | 2015-09-30 |
1336517721 | Krispin Mayfield | Counselor | 10011 Se Division St., Suite 203, Portland, OR 97266 | 2015-09-02 |
1407247927 | Syrena Nicholson | Community Health Worker | 7721 Se 92nd Avenue, Apt K, Portland, OR 97266 | 2015-02-06 |
1659777886 | Berhanu Aynalem Mekbib | Adult Companion | 9125 Sw 55th, El Dorado, Portland, OR 97266 | 2014-11-17 |
1871930685 | Felicitas Amelia Penaloza | Behavioral Analyst | 9911 Se Mt.scott Boulevard, Portland, OR 97266 | 2013-06-03 |
1710237326 | Janna Renee Higgins | Case Manager/Care Coordinator | 9911 Se Mt. Scott Boulevard, Portland, OR 97266 | 2012-09-12 |
1336403310 | Ignatius Mccarthy | Case Manager/Care Coordinator | 9911 Se Mt. Scott Boulevard, Portland, Oregon 97266, Portland, OR 97266 | 2012-06-25 |
Find all providers in zip 97266 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952940298 | New Start Program | Clinic/Center | 12180 Se Market St, Portland, OR 97216-3923 | 2020-01-03 |
1447605258 | Crestview Recovery Services, LLC | Clinic/Center | 6027 Se Belmont St, Portland, OR 97215-1927 | 2016-04-29 |
1669856571 | Portland Iop, LLC | Clinic/Center | 748 Se 181st Ave, Portland, OR 97233-4945 | 2015-07-10 |
1801947668 | Crc Health Oregon, LLC | Clinic/Center | 324 Nw Davis St., Portland, OR 97209 | 2007-01-16 |
1558412320 | Crc Health Oregon, LLC | Clinic/Center | 2600 Se Belmont St, Portland, OR 97214 | 2007-01-16 |
1932250719 | Crc Health Oregon, LLC | Clinic/Center | 6601 Ne 78th Court, Ste A3, Portland, OR 97218 | 2007-01-16 |
1326056433 | Lutheran Community Services Northwest | Clinic/Center | 605 Se Cesar E Chavez Blvd, Portland, OR 97214-3216 | 2006-08-04 |
1952360760 | Transitions Counseling, Inc. | Clinic/Center | 583 Forest Ave, Portland, ME 04101-1547 | 2006-03-21 |
1194297671 | Silver Lining Treatment Center (dba) Recovery Blvd | Clinic/Center | 10209 Se Division St Bldg D, Portland, OR 97266-1372 | 2018-12-21 |
1316417397 | Guardian Portland LLC | Clinic/Center | 17 Bishop St, Portland, ME 04103-2659 | 2018-12-03 |
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.