Organization
LIFE GUIDE N.W., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVIE BRADFORD HOGGANS MS, CACD III, QMHP (PROGRAM DIRECTOR)
(503) 255-2742
Entity
Organization
Contact information
Practice address
13232 SE STARK ST STE 3, PORTLAND, OR 97233-1573
(503) 255-2742
(503) 255-2742
Mailing address
13232 SE STARK ST STE 3, PORTLAND, OR 97233-1573
(503) 255-2742
(503) 255-2742
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
04/08/2010
Last updated
04/12/2010
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