ALBERTINA KERR CENTERS (NPI# 1679800197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679800197 |
| Entity Type | Organization |
| Organization Name | ALBERTINA KERR CENTERS |
| Practice Address |
722 Ne 162nd Ave Portland OR 97230-5760 |
| Practice Telephone | 5032398101 |
| Practice Fax Number | 5034085021 |
| Mailing Telephone | 5032398101 |
| Mailing Fax Number | 5034085021 |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2009-11-04 |
| Authorized Official Name | MR. CHRIS KRENK (PRESIDENT CEO) |
| Authorized Official Telephone | 5032398101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720446859 | Albertina Kerr Centers | Psychologist | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225-5104 | 2016-02-03 |
| 1124407770 | Albertina Kerr Centers | Case Management | 424 Ne 22nd Ave, Portland, OR 97232-2809 | 2015-05-28 |
| 1760673040 | Albertina Kerr Centers | Community/Behavioral Health | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2007-08-05 |
| 1003030305 | Albertina Kerr Centers | Community Based Residential Treatment Facility, Mental Illness | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2007-04-11 |
| 1477618353 | Albertina Kerr Centers | Residential Treatment Facility, Emotionally Disturbed Children | 722 Ne 162nd Ave, Portland, OR 97230 | 2006-12-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ALBERTINA KERR CENTERS | 424 Ne 22nd Ave, Portland, OR 97232 |
| Oregon Corporations, Companies and Business Names | ALBERTINA KERR CENTERS FOUNDATION, INC. | 424 Ne 22nd Ave, Portland, OR 97232 |
| Street Address |
722 NE 162ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-5760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235237983 | Catherine N. Knox | Counselor | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2006-09-20 |
| 1548860463 | Michele Renee Coon | Counselor | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-10-29 |
| 1710594551 | Anna Christine Peaslee | Social Worker | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-09-25 |
| 1164040739 | Samantha Bedker | Social Worker | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-07-10 |
| 1417572033 | Veronica Shiu Knight | Social Worker | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-06-09 |
| 1215550850 | Nathalie Wuebkes | Technician | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-05-18 |
| 1104446509 | Erin Marie Mcdermott | Behavior Technician | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-04-26 |
| 1174150536 | Jessica Schnur | Marriage & Family Therapist | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-03-25 |
| 1710529714 | Dickovita Kankanamge Nirmani Tilakasena | Counselor | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2019-10-10 |
| 1568003978 | Sarah Lehman | Technician | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2019-10-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| Find all providers in zip 97230 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154758266 | Youth Guidance Association | Residential Treatment Facility, Emotionally Disturbed Children | 2730 Ne Flanders St, Portland, OR 97232-3160 | 2013-10-03 |
| 1306288071 | The Inn, Home for Boys | Residential Treatment Facility, Emotionally Disturbed Children | 8940 Se 72nd Ave, Portland, OR 97206-9417 | 2013-07-23 |
| 1669666061 | Thelissa D Casley | Residential Treatment Facility, Emotionally Disturbed Children | 4818 Ne 101st Ave, Portland, OR 97220-3319 | 2007-08-29 |
| 1336795905 | Amy North | Residential Treatment Facility, Emotionally Disturbed Children | 11035 Ne Sandy Blvd, Portland, OR 97220-2553 | 2019-08-09 |
| 1710439740 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2016-10-25 |
| 1538570551 | Trillium Family Service | Residential Treatment Facility, Emotionally Disturbed Children | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2014-05-13 |
| 1619395530 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2014-03-29 |
| 1154686632 | Parry Center for Children | Residential Treatment Facility, Emotionally Disturbed Children | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2012-07-10 |
| 1720344450 | Morrison Child & Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 9911 Se Mount Scott Blvd, Portland, OR 97266-6302 | 2012-04-06 |
| 1760766349 | Jennifer Garcia | Residential Treatment Facility, Emotionally Disturbed Children | 9911 Se Mount Scott Blvd, Portland, OR 97266-6302 | 2011-09-30 |
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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.