Provider Demographics
NPI:1447577960
Name:NEIGHBORHOOD HOUSE
Entity Type:Organization
Organization Name:NEIGHBORHOOD HOUSE
Other - Org Name:HEAD START
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROADWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-432-6773
Mailing Address - Street 1:7780 SW CAPITOL HWY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-2477
Mailing Address - Country:US
Mailing Address - Phone:503-246-1663
Mailing Address - Fax:
Practice Address - Street 1:7780 SW CAPITOL HWY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2477
Practice Address - Country:US
Practice Address - Phone:503-246-1663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management