| NPI | 1245784222 |
|---|---|
| Doing Business As | LIFE RENEWAL - SHEDD OUTPATIENT |
| Doing Business As | LIFE RENEWAL - PORTLAND OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | BRIAN NELSON COO 971-255-0658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2024-02-28 |