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NPI Code Detail

MEDICARE: SOBER LIVING OREGON RECOVERY CENTER

MEDICARE: SOBER LIVING OREGON RECOVERY CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center
2251S00000XCommunity/Behavioral Health Agency
3261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1073081881
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOBER LIVING OREGON RECOVERY CENTER
Provider Business Mailing Address
First Line : 1010 5TH ST
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-2444
Country : US
Telephone Number : 503-954-1890
Fax Number : 971-888-4607
Provider Business Practice Location Address
First Line : 1010 5TH ST
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-2444
Country : US
Telephone Number : 503-954-1890
Fax Number : 971-888-4607
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : SERENNA LYNN MACLACHLAN
Credential : QMHP CADC III
Telephone Number : 916-860-9900
Provider Enumeration Date : 11/09/2018
Last Update Date : 01/21/2026

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Directions to “SOBER LIVING OREGON RECOVERY CENTER ” Practice Location

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