Organization
NEW START PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY CARL WILLIAMS CADC II (SUDS COUNSELOR)
(503) 789-2430
Entity
Organization
Contact information
Practice address
12180 SE MARKET ST, PORTLAND, OR 97216-3923
(971) 279-4993
(971) 888-4626
Mailing address
7702 SE SPRINGWATER DR, PORTLAND, OR 97206-0662
(503) 789-2430
(971) 888-4626
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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