STULTS HOUSE (NPI# 1780043802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780043802 |
| Entity Type | Organization |
| Organization Name | STULTS HOUSE |
| Practice Address |
805 Se 151st Ave Portland OR 97233-2916 |
| Practice Telephone | 9712717270 |
| Mailing Telephone | 9712717270 |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |
| Authorized Official Name | AMY LUGO (HR COORDINATOR) |
| Authorized Official Telephone | 5036666575 |
| Is Organization Subpart | Y |
| Parent Organization Name | TELECARE MENTAL HEALTH SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
805 SE 151ST AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-2916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134384688 | Jamie Deruyter | Counselor | 805 Se 151st Ave, Portland, OR 97233-2916 | 2008-07-24 |
| 1740895762 | Elisabeth Herzog | Case Manager/Care Coordinator | 805 Se 151st Ave, Portland, OR 97233-2916 | 2020-09-15 |
| 1255943106 | Katherine Colleen Pacheco | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2020-08-21 |
| 1346885019 | Timothy Sims | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-11-17 |
| 1629612411 | Shannon Marie Stronach | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-11-05 |
| 1477194330 | Daneen Pray | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-10-02 |
| 1639720998 | Paula Keyth | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-09-26 |
| 1376001792 | Jordan Alexander Niles | Case Manager/Care Coordinator | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-03-05 |
| 1619434743 | Joel T Kirkpatrick | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-02-25 |
| 1588132401 | Chase Steven Hardt | Psychiatric Residential Treatment Facility | 805 Se 151st Ave, Portland, OR 97233-2916 | 2018-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033088 | Palms Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1500 Forest Ave Apt 13d, Portland, ME 04103-1846 | 2020-11-06 |
| 1194340646 | Veritas Care of Maine Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 570 Brighton Ave Ste 2, Portland, ME 04102-2355 | 2020-06-10 |
| 1790321578 | Supportive Partnerships | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Fellows St, Portland, ME 04103-2414 | 2019-11-26 |
| 1437792199 | Atlantic Community Support LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 75 Bishop St Ste 13, Portland, ME 04103-2614 | 2019-10-24 |
| 1396390811 | Golden Group Home Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 40 Bernard Rd, Portland, ME 04103-3611 | 2019-08-02 |
| 1518022763 | Granite Bay Care, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1037 Forest Ave, Portland, ME 04103-3396 | 2006-12-27 |
| 1700407665 | Hope Family Partners LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1350 Forest Ave Apt 16, Portland, ME 04103-1815 | 2020-05-01 |
| 1770722902 | Maine Resource Development Corp | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 18 Lincoln St, Portland, ME 04103-4408 | 2009-02-11 |
| 1295994804 | Spurwink Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 899 Riverside St, Portland, ME 04103-1070 | 2008-06-09 |
| 1427256718 | Jennifer Yuenching Lui | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2007-07-07 |
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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.