Organization
MENTOR ABI
Active
Other names
Oregon Orchid
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS CUTLER (BUSINESS DIRECTOR)
(618) 457-4729
Entity
Organization
Contact information
Practice address
9125 SW 55TH AVE, PORTLAND, OR 97219-5018
(503) 258-2440
(503) 255-1042
Mailing address
10150 HIGHLAND MANOR DR STE 140, TAMPA, FL 33610-9712
(813) 626-1444
(813) 621-0770
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/01/2010
Last updated
04/01/2010
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