Healthcare Provider Details

I. General information

NPI: 1104731306
Provider Name (Legal Business Name): ARIAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2156 SW14TH DR
GRESHAM OR
97080
US

IV. Provider business mailing address

2156 SW14TH DR
GRESHAM OR
97080
US

V. Phone/Fax

Practice location:
  • Phone: 949-861-0190
  • Fax:
Mailing address:
  • Phone: 949-861-0190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TEKESTE K SEIFU
Title or Position: OWNER
Credential:
Phone: 949-861-0190