Organization
DEPAUL TREATMENT CENTERS
Active
Organization
DEPAUL TREATMENT CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA BRYANT RN (DETOXIFICATION NURSE)
(503) 535-1150
Entity
Organization
Contact information
Practice address
4310 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1404
(503) 535-1151
(503) 546-8340
Mailing address
PO BOX 3007, PORTLAND, OR 97208-3007
(503) 535-1151
(503) 546-8340
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
201140843RN
OR
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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