Exodus LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

EXODUS LLC

Practice address

21321 SE Alder St
Gresham, OR 97030-2419

Phone

(708) 632-3841

Fax

(708) 632-3841

NPI assigned

Jul 4, 2026

Last updated

Jul 4, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bereket Woticha

Title

Director

Phone

(708) 632-3841

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1783123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783123200000",
    "number": "1205753795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 SE ALDER ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 SE ALDER ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302419",
            "telephone_number": "708-632-3841",
            "fax_number": "708-632-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-04",
        "last_updated": "2026-07-04",
        "certification_date": "2026-07-04",
        "status": "A",
        "authorized_official_last_name": "WOTICHA",
        "authorized_official_first_name": "BEREKET",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "708-632-3841"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.