Organization
ALBERTINA KERR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG J BARON BA (SKILLS TRAINER, CARE COORDINATOR)
(503) 709-2806
Entity
Organization
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 709-2806
Mailing address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 709-2806
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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