Organization
CGCG II, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN CARROLL (PRESIDENT)
(503) 701-7931
Entity
Organization
Contact information
Practice address
300 14TH ST SE, SALEM, OR 97301-6311
(503) 508-9735
Mailing address
12955 SW OXALIS TER, TIGARD, OR 97223-5656
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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