Organization
SAM RECOVERY HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FUAD ABDINOR MOHAMED ETC (CEO)
(971) 386-7444
Entity
Organization
Contact information
Practice address
16132 NE GLISAN ST, PORTLAND, OR 97230-5439
(971) 386-7444
Mailing address
16132 NE GLISAN ST, PORTLAND, OR 97230-5439
(971) 386-7444
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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