Organization
AWAKENINGS BY THE SEA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRIS HANSEN BS, CADCII, NCACII (CLINICAL DIRECTOR)
(503) 738-7700
Entity
Organization
Contact information
Practice address
1325 N HOLLADAY DR, SEASIDE, OR 97138-7131
(503) 738-7700
(503) 738-7733
Mailing address
1325 N HOLLADAY DR, SEASIDE, OR 97138-7131
(503) 738-7700
(503) 738-7733
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
04-11-57U
OR
Other
Enumeration date
09/18/2007
Last updated
04/28/2010
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