Provider Demographics
NPI:1508073651
Name:METRO TREATMENT OF OREGON LP
Entity Type:Organization
Organization Name:METRO TREATMENT OF OREGON LP
Other - Org Name:PORTLAND METRO TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-351-7080
Mailing Address - Street 1:2500 MAITLAND CENTER PARKWAY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4174
Mailing Address - Country:US
Mailing Address - Phone:407-351-7080
Mailing Address - Fax:407-351-6930
Practice Address - Street 1:16420 SE DIVISION ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-1987
Practice Address - Country:US
Practice Address - Phone:503-762-3130
Practice Address - Fax:503-762-3199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METRO TREATMENT OF OREGON LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-17
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR251S00000X
261QM2800X, 332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No251S00000XAgenciesCommunity/Behavioral Health
No332900000XSuppliersNon-Pharmacy Dispensing Site