DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: CENTRAL CITY CONCERN, INC

MEDICARE: CENTRAL CITY CONCERN, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1285445585
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL CITY CONCERN, INC
Provider Business Mailing Address
First Line : 121 NW EVERETT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97209-4049
Country : US
Telephone Number : 503-294-1681
Fax Number :
Provider Business Practice Location Address
First Line : 1616 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-1453
Country : US
Telephone Number : 971-271-6066
Fax Number :
Authorized Official
Title or Position : PRESIDENT & CEO
Name : ANDREW B MENDENHALL
Credential : MD
Telephone Number : 413-584-2173
Provider Enumeration Date : 01/15/2025
Last Update Date : 04/09/2026

Similar Medicare Providers

1437618691 — GABRIELLE ANN KELLY MD
Practice Location Address:
1616 E BURNSIDE ST
PORTLAND, OR
97214-1453
Practice Phone: 971-271-6066
Practice Fax:
1548071848 — CENTRAL CITY CONCERN, INC
Practice Location Address:
1616 E BURNSIDE ST RM 504
PORTLAND, OR
97214-1453
Practice Phone: 971-271-6061
Practice Fax:
1295531184 — MONIQUE LERNO
Practice Location Address:
1616 E BURNSIDE ST
PORTLAND, OR
97214-1453
Practice Phone: 971-271-6066
Practice Fax:
1962208397 — WANIDA HULETT
Practice Location Address:
1616 E BURNSIDE ST
PORTLAND, OR
97214-1453
Practice Phone: 971-271-6066
Practice Fax:
1255139176 — JONATHAN LEE
Practice Location Address:
1616 E BURNSIDE ST
PORTLAND, OR
97214-1453
Practice Phone: 971-271-6066
Practice Fax:
1386442127 — CHELSEA DONNOR
Practice Location Address:
1616 E BURNSIDE ST
PORTLAND, OR
97214-1453
Practice Phone: 971-271-6066
Practice Fax:

Directions to “CENTRAL CITY CONCERN, INC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.