Organization
BROOKSIDE CENTER
Active
Organization
BROOKSIDE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY DEAN GONZALES BS (MILIUE COUNSELOR)
(503) 571-0884
Entity
Organization
Contact information
Practice address
10180 SE SUNNYSIDE RD, 1ST FLOOR, WING A, CLACKAMAS, OR 97015-8970
(503) 571-0884
(503) 571-0866
Mailing address
10180 SE SUNNYSIDE RD, 1ST FLOOR, WING A, CLACKAMAS, OR 97015-8970
(503) 571-0884
(503) 571-0866
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
284300000X
OR
Other
Enumeration date
04/02/2012
Last updated
06/01/2021
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