NPIMap

Organization Active NPI

Trillium Family Services

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
National Provider Identifier
1326238809
Registry record updated Jul 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
TRILLIUM FAMILY SERVICES
Practice address
3830 NE 21St Ave
Portland, OR 97212-1429
Phone
(541) 520-1095
NPI assigned
Jul 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2007

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

Authorized official

Name
Brittany Alyce Goeman
Title
Child and Adolescent Treatment Spec
Phone
(541) 520-1095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X OR Primary

Addresses

Primary practice location

3830 NE 21St Ave
Portland, OR 97212-1429

Mailing address

3830 NE 21St Ave
Portland, OR 97212-1429
Phone (541) 520-1095

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185840000000",
    "number": "1326238809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 NE 21ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121429",
            "telephone_number": "541-520-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 NE 21ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121429",
            "telephone_number": "541-520-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2007-07-31",
        "status": "A",
        "authorized_official_last_name": "GOEMAN",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "ALYCE",
        "authorized_official_title_or_position": "CHILD AND ADOLESCENT TREATMENT SPEC",
        "authorized_official_telephone_number": "541-520-1095"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; 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.