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Organization
LIFE GUIDE N.W., LLC
Active
Organization
LIFE GUIDE N.W., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVIE BRADFORD HOGGANS MS, CACD III, QMHP (PROGRAM DIRECTOR)
(503) 255-2742
Entity
Organization
Contact information
Practice address
13232 SE STARK ST STE 3, PORTLAND, OR 97233-1573
(503) 255-2742
(503) 255-2742
Mailing address
13232 SE STARK ST STE 3, PORTLAND, OR 97233-1573
(503) 255-2742
(503) 255-2742
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
04/08/2010
Last updated
04/12/2010
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