Lukedorf

NPI #1710271861 in Gresham, Oregon

Provider Information

NPI Number: 1710271861
Entity Type: Organization
Organization Name: Lukedorf
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Jun 7, 2011
Last Updated: Jun 7, 2011

Practice Location

Address: 360 SW 6TH ST
City: Gresham
State: Oregon
ZIP Code: 97080-9475
Phone: (503) 726-3806

Authorized Official

Name: MS. MEGAN WIEGEL
Title: HR
Phone: (503) 726-3698

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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