Organization
ALTORIS BEHAVIOR SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY EARL CARSON (CHAIRMAN & CEO)
(503) 803-7335
Entity
Organization
Contact information
Practice address
3880 SE 8TH AVE STE 105, PORTLAND, OR 97202-3772
(503) 803-7335
Mailing address
3880 SE 8TH AVE STE 105, PORTLAND, OR 97202-3772
(503) 803-7335
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500718376
—
OR
Enumeration date
05/28/2020
Last updated
05/28/2020
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