# TRILLIUM FAMILY SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538570551
- **Authorized official:** MARISELA JOHNSON (SKILL TRAINER)
- **Authorized official phone:** (503) 243-9591

## Contact information

- **Practice address:** 3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
- **Practice address phone:** (503) 234-9591
- **Mailing address:** 3415 SE POWELL BLVD, PORTLAND, OR 97202-3371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/13/2014
- **Last updated:** 05/13/2014