Organization
WILD LILAC CHILD DEVELOPMENT COMMUNITY
Active
Organization
WILD LILAC CHILD DEVELOPMENT COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATE STATMAN-WEIL MS (EXECUTIVE DIRECTOR)
(503) 236-3240
Entity
Organization
Contact information
Practice address
1533 SE 32ND AVE, PORTLAND, OR 97214-5008
(503) 236-3240
Mailing address
1533 SE 32ND AVE, PORTLAND, OR 97214-5008
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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