Organization
FORA HEALTH INC.
Active
Other names
DE PAUL TREATMENT CENTERS, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
MALLORY JUANITA-ANN JOHNSON (CONTRACT COORDINATOR)
(503) 535-1156
Entity
Organization
Contact information
Practice address
10230 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216
(503) 535-1150
(503) 535-1190
Mailing address
P.O.BOX 16040, PORTLAND, OR 97292
(503) 535-1150
(503) 535-1190
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OR
101YM0800X
Mental Health Counselor
—
OR
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
OR
261QM0850X
Adult Mental Health Clinic/Center
—
OR
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
OR
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
OR
320800000X
Mental Illness Community Based Residential Treatment Facility
—
OR
324500000X
Substance Abuse Rehabilitation Facility
—
OR
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299811
—
OR
Enumeration date
02/01/2007
Last updated
07/27/2022
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