Healthcare Provider Details

I. General information

NPI: 1235959305
Provider Name (Legal Business Name): ACADIA HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10763 SW GREEBURG RD. 100
TIGARD OR
97223
US

IV. Provider business mailing address

1242 SW 11TH AVE
PORTLAND OR
97205-2081
US

V. Phone/Fax

Practice location:
  • Phone: 503-558-6979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE CHAYADI
Title or Position: MEMBER
Credential: CADC
Phone: 503-964-8051