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General NPI Number Information
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NPI Number | 1447121736
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Entity Type | Organization
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Legal Business Name | EBENEZER'S KIND HEART
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 112 BELLE CT
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City | OREGON CITY
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State | OR
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Zip | 97045-3602
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Country | US
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Telephone | 971-533-4427
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Fax | 503-303-9544
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Provider Business Mailing Address
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Address Line | 112 BELLE CT
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City | OREGON CITY
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State | OR
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Zip | 97045-3602
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Country | US
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Telephone | 971-533-4427
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Fax | 503-303-9544
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Authorized Official
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Title or Position | CEO
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Name | MILIKOO ANBASSA
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Credential |
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Telephone | 971-533-4427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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