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General NPI Number Information
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NPI Number | 1477364065
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Entity Type | Organization
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Legal Business Name | HOPELINE HEALTH CENTER LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 10121 SE SUNNYSIDE RD
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City | CLACKAMAS
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State | OR
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Zip | 97015-5745
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Country | US
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Telephone | 503-534-6406
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Fax |
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Provider Business Mailing Address
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Address Line | 4515 SE WHITE LAKE RD
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City | MILWAUKIE
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State | OR
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Zip | 97222-5244
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DILNESAHU NUKURO
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Credential |
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Telephone | 240-640-4127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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