72ND AVE RECOVERY CENTER – NPI #1659453686
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Mental Illness

72ND AVE RECOVERY CENTER is a community based residential treatment facility located in PORTLAND, OR. NPPES has assigned the NPI number 1659453686 to 72ND AVE RECOVERY CENTER on October 19, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “72ND AVE RECOVERY CENTER” is a dba name, the actual legal business name for this organization is TELECARE MENTAL HEALTH SERVICES OF OREGON, INC. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

The NPI profile was previously updated about 3 years ago on May 17, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 72ND AVE RECOVERY CENTER below.

NPI Profile for
TELECARE MENTAL HEALTH SERVICES OF OREGON, INC

NPI Number
1659453686
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
TELECARE MENTAL HEALTH SERVICES OF OREGON, INC
Doing Business As (dba): 72ND AVE RECOVERY CENTER
Primary location
7759 SE 72ND AVE
PORTLAND, OR 97206-7921
Phone: (503) 788-4500 Fax: (503) 788-4506
Mailing address
1080 MARINA VILLAGE PKWY STE 100
ALAMEDA, CA 94501-1078
Phone: (510) 337-7950 Fax: (510) 337-7969
Organization Subpart
No
Authorized Official
LORENA LOPEZ
PROVIDER RELATIONS SUPERVISOR
Phone: (510) 337-7950
Updated
Certification Date
May 17, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.