Sunnyside Hood Residencial Treatment Home LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

SUNNYSIDE HOOD RESIDENCIAL TREATMENT HOME LLC

Practice address

12423SE Blaine Drive
Clackamas, OR 97015-6658

Phone

(503) 808-0865

Fax

(503) 427-2410

NPI assigned

Mar 16, 2026

Organization subpart

No

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

Authorized official

Name

Eskender Hagos Tesfaye

Title

Director

Phone

(503) 808-0865

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1437006582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15576 SE THORNBRIDGE DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156658",
            "telephone_number": "503-808-0865",
            "fax_number": "503-427-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12423SE BLAINE DRIVE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156658",
            "telephone_number": "503-808-0865",
            "fax_number": "503-427-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE HOOD RESIDENCIAL TREATMENT HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "TESFAYE",
        "authorized_official_first_name": "ESKENDER",
        "authorized_official_middle_name": "HAGOS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "503-808-0865"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.