Organization · NPI-2
4d Mental Health Services
Clinic/Center, Adult Mental Health · Portland, OR
NPI number1336997188
StatusActive
Last updated in NPPESMay 7, 2024
Details
- NPI
- 1336997188
- Entity type
- Organization (NPI-2)
- Legal business name
- 4d Mental Health Services
- Organization subpart
- Yes
- Enumeration date
- May 7, 2024
- Certification date
- May 7, 2024
- Last updated
- May 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Practice location
11010 Se Division St Ste 200Portland, OR 97266-6400
Phone 971-703-4623
Mailing address
11010 Se Division St Ste 200Portland, OR 97266-6400
Phone 971-703-4623
Authorized official
Nicholas Mathias Thomas Crapser
Clinical Director
9714420044
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