Organization
DEPAUL YOUTH AND FAMILY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHANAKO M ALDRICH CADCI QMHA (GIRLS PROGRAM SUPERVISIOR)
(503) 535-1150
Entity
Organization
Contact information
Practice address
4310 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1404
(503) 535-1150
Mailing address
4310 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1404
(503) 535-1150
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/27/2007
Last updated
08/08/2008
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