72ND AVE RECOVERY CENTER
NPI 1659453686
Community Based Residential Treatment Facility, Mental Illness in Portland, OR

NPI Status: Active since October 19, 2006

Contact Information

7759 SE 72ND AVE
PORTLAND, OR
ZIP 97206
Phone: (503) 788-4500
Fax: (503) 788-4506

NPI Profile Information
Primary Taxonomy
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Community Based Residential Treatment Fa...
CLIA Number: 38D2253536
CLIA Cert. Type: Other - RESIDENTIAL TREATMENT FAC
CLIA Exp. Date: 02-21-2026

About 72ND AVE RECOVERY CENTER

This page provides the complete NPI Profile along with additional information for 72nd Ave Recovery Center, a provider established in Portland, Oregon operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1659453686 assigned on October 2006. The practitioner's primary taxonomy code is 320800000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as 72nd Ave Recovery Center. The authorized official of this NPI record is Lorena Lopez (Provider Relations Supervisor)

NPI: 1659453686
Provider Legal Name: TELECARE MENTAL HEALTH SERVICES OF OREGON, INC
Other Organization Name: 72ND AVE RECOVERY CENTER
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 7759 SE 72ND AVE PORTLAND, OR 97206
Location Phone: (503) 788-4500
Location Fax: (503) 788-4506
Mailing Address: 1080 MARINA VILLAGE PKWY STE 100 ALAMEDA, CA 94501
Mailing Phone: (510) 337-7950
Mailing Fax: (503) 788-4506
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 10-19-2006
Last Update Date: 05-17-2023
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Community Based Residential Treatment Facility, Mental Illness
Taxonomy Code: 320800000X
Type: Residential Treatment Facilities
Taxonomy Description: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: LORENA LOPEZ
Authorized Official Title: PROVIDER RELATIONS SUPERVISOR
Authorized Official Phone: (510) 337-7950

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 38D2253536
Facility Type: Other - RESIDENTIAL TREATMENT FAC
Certificate Effective Date: February 22, 2024
Certificate Expiration Date: February 21, 2026
Laboratory Director: SCOTT C. TUCKER
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to 72nd Ave Recovery Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	6	5	9	4	5	3	6	8	6
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	6	10	9	8	5	6	6	16
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 0 + 9 + 8 + 5 + 6 + 6 + 1 + 6 + 24 = 74
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 74 = 6									6

The NPI number 1659453686 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

MR. SEAN WESTLEY FRIEND BS, QMHA

Social Worker

(Clinical)

7759 SE 72ND AVE
PORTLAND, OR
ZIP 97206

About 72ND AVE RECOVERY CENTER

Location Map

Specialty - Primary Taxonomy

Community Based Residential Treatment Facility, Mental Illness

Authorized Official

LORENA LOPEZ

CLIA Information

Reviews for 72ND AVE RECOVERY CENTER

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions

What is TELECARE MENTAL HEALTH SERVICES OF OREGON, INC's NPI number?

Where is the provider located?

What is the provider's specialty?