Organization
FDS ALLIANCE RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEMECHIS ABDISSA RN (MANAGING MEMBER)
(971) 431-6436
Entity
Organization
Contact information
Practice address
380 NE 178TH AVE, PORTLAND, OR 97230-6658
(971) 431-6436
Mailing address
380 NE 178TH AVE, PORTLAND, OR 97230-6658
(971) 431-6436
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/03/2026
Last updated
02/03/2026
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