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General NPI Number Information
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NPI Number | 1447069547
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Entity Type | Organization
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Legal Business Name | HARMONY RESIDENTIAL TREATMENT CENTRE
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 1620 NE COUNTRY CLUB AVE
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City | GRESHAM
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State | OR
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Zip | 97030-4431
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Country | US
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Telephone | 458-262-4514
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 NE COUNTRY CLUB AVE
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City | GRESHAM
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State | OR
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Zip | 97030-4431
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Country | US
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Telephone | 458-262-4514
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | WILSON PAUL KISAMBIRA
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Credential |
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Telephone | 781-309-8976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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