Healthcare Provider Details

I. General information

NPI: 1477329530
Provider Name (Legal Business Name): SMILING SPRINGS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6246 SE WICKER CT
HILLSBORO OR
97129-7797
US

IV. Provider business mailing address

6246 SE WICKER CT
HILLSBORO OR
97129-7797
US

V. Phone/Fax

Practice location:
  • Phone: 503-208-6772
  • Fax:
Mailing address:
  • Phone: 503-208-6772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRUK E SAHILU
Title or Position: OWNER
Credential:
Phone: 503-208-6772