Organization
BAYMAX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYANTUS TOLLOSA (OWNER)
(240) 470-2210
Entity
Organization
Contact information
Practice address
2819 NE 155TH AVE, PORTLAND, OR 97230-4492
(240) 470-2210
Mailing address
2819 NE 155TH AVE, PORTLAND, OR 97230-4492
(240) 470-2210
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/18/2025
Last updated
09/23/2025
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