Provider Demographics
NPI:1447069547
Name:HARMONY RESIDENTIAL TREATMENT CENTRE
Entity type:Organization
Organization Name:HARMONY RESIDENTIAL TREATMENT CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILSON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KISAMBIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-309-8976
Mailing Address - Street 1:1620 NE COUNTRY CLUB AVE
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-4431
Mailing Address - Country:US
Mailing Address - Phone:458-262-4514
Mailing Address - Fax:
Practice Address - Street 1:1620 NE COUNTRY CLUB AVE
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-4431
Practice Address - Country:US
Practice Address - Phone:458-262-4514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility