205 Yacob RTH, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

205 YACOB RTH, LLC

Practice address

9350 SE Taylor St
Portland, OR 97216-2126

Phone

(503) 830-7800

NPI assigned

Sep 15, 2026

Last updated

Sep 15, 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

Agernesh N Bogale

Title

Owner

Phone

(503) 830-7800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1789430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1659282853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 SE TAYLOR ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162126",
            "telephone_number": "503-296-2905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 SE TAYLOR ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162126",
            "telephone_number": "503-830-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "205 YACOB RTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "BOGALE",
        "authorized_official_first_name": "AGERNESH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-830-7800"
    },
    "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 Portland, OR
• Providers in Portland, 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 Sep 15, 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.