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Organization

IMANI RESIDENTIAL TREATMENT HOME

Active
Parent organization
IMANI MENTAL HEALTH AND WELLNESS LLC
Other names
IMANI RESIDENTIAL TREATMENT HOME
Organization subpart
Yes

Provider details

NPI number
Legal business name
IMANI MENTAL HEALTH AND WELLNESS LLC
Authorized official
MS. SUSAN MBUGUA PMHNP-BC (ADMINSTRATOR)
(214) 458-1713
Entity
Organization

Contact information

Practice address
14325 SW WILSON DR, BEAVERTON, OR 97008-6140
(971) 357-1234
Mailing address
14325 SW WILSON DR, BEAVERTON, OR 97008-6140
(971) 357-1234

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
04/01/2026
Last updated
04/01/2026
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