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Organization

THE INN, HOME FOR BOYS

Active
Other names
The Inn
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS J MITCHELL (EXECUTIVE DIRECTOR)
(503) 234-8757
Entity
Organization

Contact information

Practice address
8940 SE 72ND AVE, PORTLAND, OR 97206-9417
(503) 777-6317
Mailing address
5605 E BURNSIDE ST, PORTLAND, OR 97215-1499
(503) 234-8757
(503) 234-8758

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
OR

Other

Enumeration date
07/23/2013
Last updated
07/23/2013
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