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Organization
WEST LINN CLEMENTINE, INC
Active
Organization
WEST LINN CLEMENTINE, INC
Active
Other names
Clementine Portland
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE BAGLEY (CHIEF FINANCIAL OFFICER)
(305) 663-1876
Entity
Organization
Contact information
Practice address
1148 ROSEMONT RD, WEST LINN, OR 97068-9235
(971) 249-8448
(503) 305-7100
Mailing address
6100 SW 76TH ST, SOUTH MIAMI, FL 33143-5002
(305) 663-1876
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
OR
Other
Enumeration date
08/05/2016
Last updated
03/04/2020
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