Organization
SOBER LIVING OREGON TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD TODD FLYNN MA (CLINICAL DIRECTOR)
(503) 897-1916
Entity
Organization
Contact information
Practice address
10209 SE DIVISION, PORTLAND, OR 97266
(503) 701-8397
Mailing address
10209 SE DIVISION ST BLDG D, PORTLAND, OR 97266-1372
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
OR
Other
Enumeration date
02/08/2018
Last updated
02/08/2018
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