Organization
DE PAUL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHABD KHALSA B.A. PSYCHOLOGY (ADMISSIONS COUNSELOR)
(503) 535-1150
Entity
Organization
Contact information
Practice address
4310 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1404
(503) 535-1150
Mailing address
PO BOX 3007, PORTLAND, OR 97208-3007
(503) 535-1150
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/04/2010
Last updated
06/04/2010
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