Organization
DE PAUL DRUG AND ALCOHOL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY FORREST LPC, LMFT (DIRECTOR OF PROFFESIONAL SERVICES)
(503) 353-1174
Entity
Organization
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1174
(503) 535-1191
Mailing address
1312 SW WASHINGTON ST, P.O. BOX 3007, PORTLAND, OR 97205-2327
(503) 535-1174
(503) 535-1191
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
05/24/2010
Last updated
05/24/2010
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