Organization · NPI-2

Acg Group

Clinic/Center · Portland, OR

NPI number1760076392
StatusActive
Last updated in NPPESJul 1, 2021

Details

NPI
1760076392
Entity type
Organization (NPI-2)
Legal business name
Acg Group
Organization subpart
No
Enumeration date
Feb 24, 2021
Certification date
Jul 1, 2021
Last updated
Jul 1, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Other names

  • Lilith Clinic (Doing Business As)

Practice location

511 Sw 10th Ave Ste 904
Portland, OR 97205-2710

Phone 503-221-1870 · Fax 503-389-7945

Mailing address

511 Sw 10th Ave Ste 904
Portland, OR 97205-2710

Phone 503-221-1870 · Fax 503-389-7945

Authorized official

Nadya Volkoff
Manager
5038840842

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