OrganizationActive
Allied Health Services
NPI 1104219211 · Substance Abuse Rehabilitation Facility · Portland, OR
Provider details
- NPI number
- 1104219211
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Michael Tierney, Director(503) 226-2203
- License
- 140333 (OR)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
324 Nw Davis St
Portland, OR 97209-3925
Phone: (503) 226-2203
Fax: (503) 223-4231
Approximate (ZIP-level) locationGet directions
Mailing address
324 Nw Davis St
Portland, OR 97209-3925
Registry dates
- Enumerated
- 2015-03-13
- Last updated
- 2024-05-14
- Certified
- 2024-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.