Carly Joanna Thompson - Portland, OR

Carly Joanna Thompson

Emotionally Disturbed Childrens' Residential Treatment Facility in Portland, Oregon

NPI 1710174404

Carly Joanna Thompson is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Portland, OR. Carly Joanna Thompson practices in Portland, OR. The NPI Number for Carly Joanna Thompson is 1710174404 and holds a License No. (Oregon).

The current practice location address for Carly Joanna Thompson is 722 Ne 162Nd Ave, Portland, OR and can be reached out via phone at 503-255-4205 and via fax at 503-261-0988.

Location: 722 Ne 162Nd Ave, Portland, OR, 97214-4432

NPI Number

1710174404

Provider Name

Carly Joanna Thompson

Credential

Provider Entity Type

Individual

Gender

Female

Address

722 Ne 162Nd Ave, Portland, OR, 97214-4432

Phone Number

503-255-4205

Fax Number

503-261-0988

Provider Enumeration Date

09/26/2007

Last Update Date

03/09/2024

Address

722 Ne 162Nd Ave

City

Portland

State

Oregon

Zip

97230-5760

Phone Number

503-255-4205

Fax Number

503-261-0988

Address

722 Ne 162Nd Ave

City

Portland

State

Oregon

Zip

97230-5760

Phone Number

503-255-4205

Fax Number

503-261-0988

Type

Residential Treatment Facilities

Classification

Residential Treatment Facility, Emotionally Disturbed Children

Speciality

Taxonomy

322D00000X

License No.

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Definition

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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