Organization
SISTERE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNAN MAYS (ADMINISTRATER)
(503) 665-5193
Entity
Organization
Contact information
Practice address
1610 W POWELL BLVD, GRESHAM, OR 97030-6843
(503) 665-5193
(503) 665-8454
Mailing address
PO BOX 582, GRESHAM, OR 97030-0137
(503) 665-5193
(503) 665-8454
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320800000X
OR
Other
Enumeration date
05/27/2009
Last updated
02/18/2010
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