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CH10766T CENTRAL CITY CONCERN (Active)
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Main Details
Name
CENTRAL CITY CONCERN
Subdivision Name
Hooper Detoxification and Stabilization Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017148
340B ID
CH10766T
Grant Number
H80CS00234
Additional Details
Current Program Status
Active
Registration Date
2/22/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/27/2019
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Central City Concern
Andrew Mendenhall, CEO
(503) 294-1681
Primary Contact
Central City Concern
Chris Lagor, Compliance Manager
(971) 361-7769
Addresses
Street Address
1535 N. Williams Ave
Portland, OR 97227-1885
Billing Address
Central City Concern
232 NW 6th Avenue
Portland, OR 97209
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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