CENTRAL CITY CONCERN (NPI# 1609084904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609084904 |
| Entity Type | Organization |
| Organization Name | CENTRAL CITY CONCERN |
| Other Organization Name | HOOPER DETOXIFICATION & STABILIZATION CENTER |
| Practice Address |
1535 N Williams Ave Portland OR 97227-1885 |
| Mailing Address |
232 Nw 6th Ave Attn: Bbis Credentialing Portland OR 97209-3609 |
| Practice Telephone | 5032382067 |
| Practice Fax Number | 5032382004 |
| Mailing Telephone | 5032941681 |
| Mailing Fax Number | 5032417419 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2017-10-26 |
| Authorized Official Name | DR. RACHEL SOLOTAROFF (PRESIDENT & CEO) |
| Authorized Official Telephone | 5032941681 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Hooper Detoxification & Stabilization Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740664960 | Central City Concern | Clinic/Center | 6847 N Interstate Ave, Portland, OR 97217-5400 | 2015-07-17 |
| 1356724322 | Central City Concern | Clinic/Center | 8066 Se Taggart St, Portland, OR 97206-1076 | 2015-07-08 |
| 1902289978 | Central City Concern | Clinic/Center | 5724 Ne Prescott St, Portland, OR 97218-2230 | 2015-07-08 |
| 1205219276 | Central City Concern | Clinic/Center | 5224 N Vancouver Ave, Portland, OR 97217-2768 | 2015-07-08 |
| 1437624046 | Central City Concern | Pharmacy | 12121 E Burnside St, Portland, OR 97216-3737 | 2018-10-10 |
| 1881078095 | Central City Concern | Clinic/Center | 18088 Se Market St, Portland, OR 97233-5055 | 2015-07-17 |
| 1033518188 | Central City Concern | Clinic/Center | 727 W Burnside St, Portland, OR 97209-3514 | 2014-08-14 |
| 1639420532 | Central City Concern | Clinic/Center | 1949 Se 122nd Ave, Portland, OR 97233-1303 | 2012-10-02 |
| 1679832315 | Central City Concern | Clinic/Center | 2545 Ne Flanders St, Portland, OR 97232-3139 | 2012-05-15 |
| 1427324466 | Central City Concern | Clinic/Center | 726 W Burnside St, Portland, OR 97209-3515 | 2012-03-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CENTRAL CITY CONCERN | 232 Nw 6th Ave, Portland, OR 97209 |
| Oregon Corporations, Companies and Business Names | CENTRAL CITY CONCERN BENEFIT AND ENTITLEMENT SPECIALIST TEAM | 33 Nw Broadway, Portland, OR 97209 |
| Oregon Corporations, Companies and Business Names | CENTRAL CITY CONCERN BEST | 33 Nw Broadway, Portland, OR 97209 |
| Oregon Corporations, Companies and Business Names | CENTRAL CITY CONCERN CLEAN START | 232 Nw 6th Ave, Portland, OR 97209 |
| Oregon Corporations, Companies and Business Names | CENTRAL CITY CONCERN DEVELOPMENT | 232 Nw 6th Ave, Portland, OR 97209 |
| Oregon Corporations, Companies and Business Names | CENTRAL CITY CONCERN FOUNDATION | 232 Nw Sixth Ave, Portland, OR 97209 |
| Oregon Corporations, Companies and Business Names | CENTRAL CITY CONCERN PHARMACY | 727 W Burnside St, Portland, OR 97209 |
| Oregon Corporations, Companies and Business Names | CENTRAL CITY CONCERN RECOVERY CENTER | 726 W Burnside St, Portland, OR 97209 |
| Street Address |
1535 N WILLIAMS AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1885 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053347591 | Andrew B Mendenhall | Family Medicine | 1535 N Williams Ave, Portland, OR 97227-1885 | 2006-06-25 |
| 1619576782 | Andrew Iokepa Kualaau | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-10-20 |
| 1679170377 | Holly Nicole Phillips | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-10-06 |
| 1326654039 | Zachary Nathan Starbuck | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-09-17 |
| 1770197071 | David Ali Jimenez | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-09-03 |
| 1720692122 | Brianna Michelle White | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-09-02 |
| 1669081816 | Sara Elizabeth Price | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-07-23 |
| 1295352979 | Anthony Michshon Hines II | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-06-29 |
| 1548882269 | Mary Ann Mukhin | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-05-15 |
| 1184253486 | Rachelle Lauren Sather | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477002228 | Treehouse Nw Inc | Substance Abuse Rehabilitation Facility | 4713 N Albina Ave, Suite 301, Portland, OR 97217-2605 | 2016-09-21 |
| 1154785475 | Blvd Centers, Inc | Substance Abuse Rehabilitation Facility | 1316 Se 12th Ave, Portland, OR 97214-3604 | 2016-04-12 |
| 1104219211 | Allied Health Services | Substance Abuse Rehabilitation Facility | 808 Se Alder St, Portland, OR 97214-2213 | 2015-03-13 |
| 1700297074 | Pathfinders of Oregon | Substance Abuse Rehabilitation Facility | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2014-05-08 |
| 1194037283 | De Paul Treatment Centers | Substance Abuse Rehabilitation Facility | 1312 Sw Washington St., Portland, OR 97208 | 2010-07-06 |
| 1649412511 | Portland Detox | Substance Abuse Rehabilitation Facility | 11160 Sw Waverly Pl, Portland, OR 97225-4456 | 2009-03-24 |
| 1144432907 | Serenity House, Inc. | Substance Abuse Rehabilitation Facility | 30 Mellen St, Portland, ME 04101-2110 | 2007-05-04 |
| 1063548436 | Milestone Foundation Inc | Substance Abuse Rehabilitation Facility | 65 India St, Portland, ME 04101-4209 | 2007-02-27 |
| 1851428775 | Depaul Treatment Centers Inc. | Substance Abuse Rehabilitation Facility | 5052 Ne 42nd Ave, Portland, OR 97218-1550 | 2007-02-27 |
| 1114546645 | Nw Insituto Latino | Substance Abuse Rehabilitation Facility | 2054 N Vancouver Ave, Portland, OR 97227-1917 | 2020-04-14 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.