Prime Care Home

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

PRIME CARE HOME

Practice address

135 NW Linneman Ave
Gresham, OR 97030-6248

Phone

(469) 688-9579

NPI assigned

Oct 25, 2025

Organization subpart

No

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

Authorized official

Name

Bezawite M Abegaz, RN

Title

Director

Phone

(469) 688-9579

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1761350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1730057431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 NW LINNEMAN AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970306248",
            "telephone_number": "469-688-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 NW LINNEMAN AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970306248",
            "telephone_number": "469-688-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-25",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "ABEGAZ",
        "authorized_official_first_name": "BEZAWITE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "469-688-9579",
        "authorized_official_credential": "RN"
    },
    "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 Gresham, OR
• Providers in Gresham, 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 Nov 13, 2025; 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.