Rose City Recovery
Clinic/Center, Mental Health (Including Community Mental Health Center) in Portland, OR. Organization (NPI-2).
NPI number1548087331
StatusActive
Last updated in NPPESJun 4, 2025
Details
- NPI
- 1548087331
- Entity type
- Organization (NPI-2)
- Legal business name
- Rose City Recovery
- Organization subpart
- No
- Enumeration date
- Sep 23, 2024
- Certification date
- Jun 4, 2025
- Last updated
- Jun 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 174200000X | Meals | – | – | |
| 251B00000X | Case Management | – | – | |
| 251S00000X | Community/Behavioral Health | – | – | |
| 261Q00000X | Clinic/Center | – | – | |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – | |
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | |
| 261QR0800X | Clinic/Center, Recovery Care | – | – | |
| 275N00000X | Medicare Defined Swing Bed Unit | – | – | |
| 310400000X | Assisted Living Facility | – | – | |
| 3104A0625X | Assisted Living Facility, Assisted Living, Mental Illness | – | – | |
| 3104A0630X | Assisted Living Facility, Assisted Living, Behavioral Disturbances | – | – | |
| 310500000X | Intermediate Care Facility, Mental Illness | – | – | |
| 343900000X | Non-emergency Medical Transport (VAN) | – | – |
Practice location
610 Se 6th AvePortland, OR 97214-2224
Phone 480-881-4555
Mailing address
610 Se 6th AvePortland, OR 97214-2224
Phone 480-881-4555
Authorized official
Raheem Jahmel Watson
Owner/Pss
4808814555
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