Organization
PRIME CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEZAWITE M ABEGAZ RN (DIRECTOR)
(469) 688-9579
Entity
Organization
Contact information
Practice address
135 NW LINNEMAN AVE, GRESHAM, OR 97030-6248
(469) 688-9579
Mailing address
135 NW LINNEMAN AVE, GRESHAM, OR 97030-6248
(469) 688-9579
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/25/2025
Last updated
11/13/2025
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