Provider Demographics
NPI:1962836262
Name:NEW VISION PROGRAMS OF OREGON
Entity Type:Organization
Organization Name:NEW VISION PROGRAMS OF OREGON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-704-9478
Mailing Address - Street 1:16172 NW KEVIN CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7287
Mailing Address - Country:US
Mailing Address - Phone:503-704-9478
Mailing Address - Fax:503-855-3440
Practice Address - Street 1:11576 SE 27TH AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7719
Practice Address - Country:US
Practice Address - Phone:503-704-9478
Practice Address - Fax:503-855-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0118322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children