Organization
EMERALD RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEKRY SEMENS (DIRECTOR)
(615) 423-8136
Entity
Organization
Contact information
Practice address
11940 SE BUSH ST, PORTLAND, OR 97266-2140
(615) 423-8136
Mailing address
11940 SE BUSH ST, PORTLAND, OR 97266-2140
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/16/2025
Last updated
10/16/2025
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