Awakenings Bybee Center LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

AWAKENINGS BYBEE CENTER LLC

Practice address

14355 N Bybee Lake CT
Portland, OR 97203-6495

Phone

(806) 669-7976

NPI assigned

Feb 4, 2022

Organization subpart

No

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

Authorized official

Name

Brody Smith

Title

Manager

Phone

(806) 669-7976

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1912651407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 N PRICE RD",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790655909",
            "telephone_number": "806-669-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14355 N BYBEE LAKE CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972036495",
            "telephone_number": "806-669-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKENINGS BYBEE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRODY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "806-669-7976"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.