Organization
DE PAUL DRUG AND ALCOHOL TREATMENT CENTER
Active
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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