Individual provider · Type 1 NPI
Lidya Yifru
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Beaverton, OR
Practice location
4780 SW 166th Ave
Beaverton, OR 97078-1955
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Worker | 172V00000X | None listed |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1033934476
Lidya Yifru's National Provider Identifier is 1033934476, issued on Nov 20, 2024. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Beaverton, OR. The record was last updated on Nov 20, 2024.