Organization
DEPAUL TREATMENT CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RASHELLE MYTYCH CADC 1 (RESIDENTIAL COUNSELOR SUPERVISOR)
(503) 535-1113
Entity
Organization
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1101
Mailing address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245378546
—
OR
Enumeration date
11/04/2016
Last updated
11/04/2016
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