Depaul Youth and Family

NPI #1841318581 in Portland, Oregon

Provider Information

NPI Number: 1841318581
Entity Type: Organization
Organization Name: Depaul Youth and Family
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Mar 27, 2007
Last Updated: Aug 8, 2008

Practice Location

Address: 4310 NE KILLINGSWORTH ST
City: Portland
State: Oregon
ZIP Code: 97218-1404
Phone: (503) 535-1150

Authorized Official

Name: MISS SHANAKO M ALDRICH, CADCI QMHA
Title: GIRLS PROGRAM SUPERVISIOR
Phone: (503) 535-1150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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Individual Providers

Provider Name	Specialty	City
Richard Ivan Vaughan, BS	Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children	Portland	AI Deep Dive
MISS Kelsey Corrine Coffey	Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children	Portland	AI Deep Dive
MS. Gail Renee Wilson	Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children	Portland	AI Deep Dive

Organizations

Provider Name	Specialty	City
Depaul Treatment Center	Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children	Portland	AI Deep Dive
De Paul Treatment Center	Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children	Portland	AI Deep Dive

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