Organization
BEACON RECOVERY RESIDENCE
Active
Organization
BEACON RECOVERY RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELESHEW AGEGNEHU (ADMINISTRATIVE DIRECTOR)
(503) 890-8171
Entity
Organization
Contact information
Practice address
3155 SW 199TH TER, ALOHA, OR 97003-2672
(503) 649-7010
Mailing address
3155 SW 199TH TER, ALOHA, OR 97003-2672
(503) 649-7010
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
10/20/2025
Last updated
08/14/2026
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