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Active NPI 1205753795 Organization (Entity Type 2)

Exodus Llc

Residential Treatment Facility, Intellectual and/or Developmental Disabilities • Gresham, OR

About Exodus Llc NPI 1205753795 Summary

Exodus Llc is a verified healthcare organization specializing in Residential Treatment Facility, Intellectual and/or Developmental Disabilities operating in Gresham, OR. Located at 21321 SE ALDER ST, this facility provides patient care and medical services under National Provider Identifier (NPI) 1205753795.

Administrative operations and authorized compliance are overseen by Bereket Woticha (Director).

Facility Location & Contact Primary Location

Facility Address

21321 Se Alder St

Gresham, OR 970302419

Telephone 7086323841

Fax 7086323841

Authorized Official Information

Authorized Contact Name

Bereket Woticha

Title / Role

Director

Official Telephone

7086323841

Facility Classifications & Specialties

Residential Treatment Facility, Intellectual and/or Developmental Disabilities Primary Taxonomy

NUCC Taxonomy Code: 320600000X

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

NUCC Taxonomy Code: 320900000X

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events

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NPI Profile Active July 04, 2026

NPI status registered as active in NPPES database

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Updated Practice Location July 04, 2026

Registered at 21321 SE ALDER ST, GRESHAM, OR 970302419 (Tel: 7086323841)

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Updated Business Mailing Address July 04, 2026

Registered at 21321 SE ALDER ST, GRESHAM, OR 970302419

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Organization / Clinic Name Updated July 04, 2026

Operating as EXODUS LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 04, 2026

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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Initial NPI Registration & Enumeration July 04, 2026

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1205753795

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: July 04, 2026

Last Update: July 04, 2026

Update or Correct Listing

Mailing Address

21321 Se Alder St

Gresham, OR 970302419

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.