Individual provider · Type 1 NPI

Sugar Ray Black

Adult Companion · Portland, OR

NPI number 1144416629 Active

Practice location

6011 N Greeley Ave Apt B
Portland, OR 97217-5057

Call (503) 238-0769 Map

Specialties and licenses

TaxonomyCodeLicense
Adult Companion Primary 372600000XNone listed

Adult Companion: An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.

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About NPI 1144416629

Sugar Ray Black's National Provider Identifier is 1144416629, issued on Sep 19, 2007. The primary taxonomy on file is Adult Companion (372600000X), and the practice location is in Portland, OR. The record was last updated on Sep 19, 2007.