Organization
EVERGREEN RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUC HIRWA N/A (MANAGING DIRECTOR)
(207) 331-0435
Entity
Organization
Contact information
Practice address
5441 S MACADAM AVE STE R, PORTLAND, OR 97239-3822
(207) 331-0435
Mailing address
5441 S MACADAM AVE STE R, PORTLAND, OR 97239-3822
(207) 331-0435
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/13/2025
Last updated
11/13/2025
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