OrganizationActive
64th Ave LLC
NPI 1912152570 · Mental Illness Community Based Residential Treatment Facility · Milwaukie, OR
Provider details
- NPI number
- 1912152570
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Rhonda Schoenborn, Managing Member/Owner
- License
- 869 (OR)
Practice location
4199 Se King Rd
Milwaukie, OR 97222-5892
Phone: (503) 786-3830
Fax: (503) 653-3534
Mailing address
4199 Se King Rd
Milwaukie, OR 97222-5892
Registry dates
- Enumerated
- 2008-11-24
- Last updated
- 2008-11-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.