Waverly Children'S Home

LBN: Trillium Family Services
Waverly Children'S Home is an health care organization with primary practice located at 3415 Se Powell Boulevard , Portland OR 97202. The organization recently has 2 registered licenses in different health care specialties including Agencies / Day Training, Developmentally Disabled Services, Agencies / Community/Behavioral Health. Agencies / Community/Behavioral Health is the primary health care specialty. Trillium Family Services can be contacted via phone (503) 205-4362, or through Venzke, Suzy via phone (503) 205-4362.

Contact Information

Primary practice address
3415 Se Powell Boulevard Portland OR 97202
Phone: (503) 205-4362
Fax: (503) 205-0193
Website:
Map and Directions
Authorized official contact:
Name: Venzke, Suzy
Phone: (503) 205-4362

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X Oregon
Agencies / Community/Behavioral Health 251S00000X Oregon

Profile Details

NPI number 1437227535
LBN Legal business name Trillium Family Services
DBA Doing business as Waverly Children'S Home
Authorized official Venzke, Suzy
Entity Organization
Organization subpart 1 No
Enumeration date Nov 30th, 2006
Last updated Mar 26th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437227535 NPPES
Oregon MEDICAID 145946

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