MEDICARE: GENTLE HANDS TREATMENT HOME LLC

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
1	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1790638625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE HANDS TREATMENT HOME LLC

Provider Business Mailing Address
First Line	:	12333 SE EAGLE GLEN DR # OR97086
Second Line	:
City	:	HAPPY VALLEY
State	:	OR
Zip	:	97086-6558
Country	:	US
Telephone Number	:	503-305-1156
Fax Number	:	503-305-1156

Provider Business Practice Location Address
First Line	:	12333 SE EAGLE GLEN DR # OR97086
Second Line	:
City	:	HAPPY VALLEY
State	:	OR
Zip	:	97086-6558
Country	:	US
Telephone Number	:	503-305-1156
Fax Number	:	503-305-1156

Authorized Official
Title or Position	:	MANAGER
Name	:	EYUEL HOSANA TEMESGEN
Credential	:	ADMINISTRATOR
Telephone Number	:	503-305-1156

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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