OrganizationActive
Core Care Residential Solutions LLC
NPI 1023828944 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Portland, OR
Provider details
- NPI number
- 1023828944
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Wilson Kisambira, Manager(781) 309-8976
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
9310 Se Duke St
Portland, OR 97266-5259
Phone: (458) 262-4514
Approximate (ZIP-level) locationGet directions
Mailing address
9310 Se Duke St
Portland, OR 97266-5259
Registry dates
- Enumerated
- 2025-01-13
- Last updated
- 2025-07-07
- Certified
- 2025-07-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.