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General NPI Number Information
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NPI Number | 1821895194
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Entity Type | Organization
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Legal Business Name | VANGUARD OR LLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 9541 SW INEZ ST
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City | TIGARD
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State | OR
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Zip | 97224-5885
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Country | US
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Telephone | 602-851-9710
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Fax |
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Provider Business Mailing Address
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Address Line | 31917 N 64TH ST
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City | CAVE CREEK
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State | AZ
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Zip | 85331-2700
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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 | CEO
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Name | LAWRENCE BRIGGS
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Credential |
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Telephone | 480-320-0752
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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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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation 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 | 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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