Provider Demographics
NPI:1194297671
Name:SILVER LINING TREATMENT CENTER (DBA) RECOVERY BLVD
Entity type:Organization
Organization Name:SILVER LINING TREATMENT CENTER (DBA) RECOVERY BLVD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CADCIII
Authorized Official - Phone:503-875-2787
Mailing Address - Street 1:1316 SE 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-3604
Mailing Address - Country:US
Mailing Address - Phone:503-875-2787
Mailing Address - Fax:
Practice Address - Street 1:10209 SE DIVISION ST BLDG D
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-1372
Practice Address - Country:US
Practice Address - Phone:503-875-2787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-21
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder