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Organization

PACIFIC COMMUNITY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERIC MANZI (OPERATIONS MANAGER)
(503) 734-5698
Entity
Organization

Contact information

Practice address
10017 NE 13TH AVE, PORTLAND, OR 97211-1563
(503) 734-5698
Mailing address
10017 NE 13TH AVE, PORTLAND, OR 97211-1563
(503) 734-5698

Taxonomy

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

Other

Enumeration date
08/07/2024
Last updated
08/07/2024
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