Organization
CASCADIA
Active
Other names
arbor place
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA DENISE BROADOUS (RESIDENTAL COUNSELOR 1)
(503) 528-0757
Entity
Organization
Contact information
Practice address
2330 NE SISKIYOU ST, PORTLAND, OR 97212-2471
(503) 528-0757
Mailing address
6902 N ALBINA AVE, PORTLAND, OR 97217-1604
(503) 288-1688
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
3726000OOX
OR
Other
Enumeration date
02/02/2007
Last updated
08/22/2020
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