Provider First Line Business Practice Location Address:
10180 SE SUNNYSIDE AVE 1ST FLOOR, WING A
Provider Second Line Business Practice Location Address:
BROOKSIDE CENTER RESIDENTIAL TREATMENT
Provider Business Practice Location Address City Name:
CLACKAMAS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97015-9303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-571-0858
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2009