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Organization
TRILLIUM FAMILY SERVICE
Active
Organization
TRILLIUM FAMILY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISELA JOHNSON (SKILL TRAINER)
(503) 243-9591
Entity
Organization
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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