Provider Demographics
NPI:1477987550
Name:ALLIES IN CHANGE
Entity Type:Organization
Organization Name:ALLIES IN CHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HUFFINE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:503-297-7979
Mailing Address - Street 1:1675 SW MARLOW AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5102
Mailing Address - Country:US
Mailing Address - Phone:503-297-7979
Mailing Address - Fax:503-297-7980
Practice Address - Street 1:1675 SW MARLOW AVE STE 110
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5102
Practice Address - Country:US
Practice Address - Phone:503-297-7979
Practice Address - Fax:503-297-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty