Individual
JOYCE BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
4101 NE DIVISION ST, GRESHAM, OR 97030-4617
(503) 666-6575
Mailing address
3443 NE 15TH ST, GRESHAM, OR 97030-4503
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
174378371
OR
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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