Provider Demographics
NPI:1184633141
Name:CLEAR PATHS INC
Entity Type:Organization
Organization Name:CLEAR PATHS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES GENERALIST
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LA VINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-363-2021
Mailing Address - Street 1:3793 RIVER RD N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-4827
Mailing Address - Country:US
Mailing Address - Phone:503-304-7002
Mailing Address - Fax:503-304-7049
Practice Address - Street 1:171 SW COURT
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338
Practice Address - Country:US
Practice Address - Phone:503-831-1423
Practice Address - Fax:503-831-1573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORACCBO970482101YA0400X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Multi-Specialty