NPIMap

Organization Active NPI

Sober Living Oregon Recovery Center

Doing business as Spark Wellness

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Oregon City, OR
National Provider Identifier
1073081881
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SOBER LIVING OREGON RECOVERY CENTER
Doing business as
Spark Wellness
Practice address
1010 5TH St
Oregon City, OR 97045-2444
Phone
(503) 954-1890
Fax
(971) 888-4607
NPI assigned
Nov 9, 2018
Last updated
Oct 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Serenna Lynn Maclachlan, QMHP CADC III
Title
Chief Executive Officer
Phone
(916) 860-9900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

1010 5TH St
Oregon City, OR 97045-2444

Mailing address

1010 5TH St
Oregon City, OR 97045-2444
Phone (503) 954-1890

Other practice location 1

104 11th St
Oregon City, OR 97045-1021
Phone (503) 954-1890

Other practice location 2

1122 NE 122nd Ave Ste A200
Portland, OR 97230-2083
Phone (503) 954-1890

Other practice location 3

108 11th St
Oregon City, OR 97045-1021
Phone (503) 954-1890

Other names 1

  • Spark Wellness Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2157964Sober Living Oregon Recovery Center LLC Dba1010 5TH St, Oregon City, OR 97045Certificate of waiverNov 15, 2026

National Provider Directory

National Provider Directory

Locations

1010 5th St
Oregon City, OR 97045
Phone (503) 594-4750

1122 NE 122nd Ave
Ste A102
Portland, OR 97230
Phone (503) 389-6536

1122 NE 122nd Ave
Ste A200
Portland, OR 97230
Phone (503) 594-4750

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790812800000",
    "number": "1073081881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 5TH ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452444",
            "telephone_number": "503-954-1890",
            "fax_number": "971-888-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 5TH ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452444",
            "telephone_number": "503-954-1890",
            "fax_number": "971-888-4607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 11th St",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970451021",
            "country_code": "US",
            "telephone_number": "503-954-1890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1122 NE 122nd Ave Ste A200",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972302083",
            "country_code": "US",
            "telephone_number": "503-954-1890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 11th St",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970451021",
            "country_code": "US",
            "telephone_number": "503-954-1890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOBER LIVING OREGON RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-09",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "MACLACHLAN",
        "authorized_official_first_name": "SERENNA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "916-860-9900",
        "authorized_official_credential": "QMHP CADC III"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spark Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.