Organization
DAVE 24HR RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWIT BERISSO (EXECUTIVE DIRECTOR)
(971) 393-6460
Entity
Organization
Contact information
Practice address
11863 E BURNSIDE ST, PORTLAND, OR 97216-3731
(971) 393-6460
Mailing address
11863 E BURNSIDE ST, PORTLAND, OR 97216-3731
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
12/15/2025
Last updated
12/15/2025
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