Healthcare Provider Details

I. General information

NPI: 1407792229
Provider Name (Legal Business Name): RIGHT AT HOME RTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 NE 19TH ST
GRESHAM OR
97030-4006
US

IV. Provider business mailing address

340 NE 19TH ST
GRESHAM OR
97030-4006
US

V. Phone/Fax

Practice location:
  • Phone: 503-607-7373
  • Fax:
Mailing address:
  • Phone: 503-607-7373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BINIYAM TESFAYE
Title or Position: PROGRAM ADMINISTRATOR
Credential:
Phone: 503-607-7373