OrganizationActive
Pacific Crest Trail Detox LLC
NPI 1043760838 · Substance Abuse Rehabilitation Facility · Milwaukie, OR
Provider details
- NPI number
- 1043760838
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Benjamin Randolph, Ceo(503) 901-1836
Specialties & taxonomies
Residential Treatment Facilities
Practice location
7708 Se Clackamas Rd
Milwaukie, OR 97267-4405
Phone: (503) 908-8875
Approximate (ZIP-level) locationGet directions
Mailing address
10600 Se Mcloughlin Blvd
Milwaukie, OR 97222-7428
Registry dates
- Enumerated
- 2016-10-05
- Last updated
- 2016-10-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.