Organization
TRILLIUM FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY ALYCE GOEMAN (CHILD AND ADOLESCENT TREATMENT SPEC)
(541) 520-1095
Entity
Organization
Contact information
Practice address
3830 NE 21ST AVE, PORTLAND, OR 97212-1429
(541) 520-1095
Mailing address
3830 NE 21ST AVE, PORTLAND, OR 97212-1429
(541) 520-1095
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
OR
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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