Organization · Type 2 NPI

Elderly and Disabled Services

Mental Illness Community Based Residential Treatment Facility · Beaverton, OR

NPI number 1831878776 Active

Practice location

19536 SW Stacey St
Beaverton, OR 97003-2521

Call (541) 261-1991 Map

Mailing address

3126 State St Ste 100
Medford, OR 97504-8665

Specialties and licenses

Taxonomy	Code	License
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	None listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

11 other providers at this address

Other mental illness community based residential treatment facility providers in Beaverton

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NPI record

NPI: 1831878776
Entity type: Organization (Type 2)
Issued: Jul 17, 2023
Last updated: Jun 17, 2025
Status: Active
Subpart: Yes of Elderly and Disabled Services

Other names

<unavail>
Restoration Home Stacey RTH · doing business as
Restoration Home Stacey RTH · doing business as

Authorized official

Larry Michael McPhee
Owner
(541) 261-1991

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About NPI 1831878776

Elderly and Disabled Services's National Provider Identifier is 1831878776, issued on Jul 17, 2023. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Beaverton, OR. The record was last updated on Jun 17, 2025.