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Organization

PREMIERE RECOVERY CENTER LLC

Active
Other names
Premiere Recovery Center
Organization subpart
No

Provider details

NPI number
Authorized official
GERALD TODD FLYNN MA (EXECUTIVE DIRECTOR)
(503) 332-4969
Entity
Organization

Contact information

Practice address
14935 SE 82ND DR, CLACKAMAS, OR 97015-9624
(503) 332-4969
Mailing address
2080 NW 160TH AVE, BEAVERTON, OR 97006-7640
(503) 332-4969

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary

Other

Enumeration date
07/27/2023
Last updated
07/27/2023
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