NPI 1043156706

Shalom Sd Rth LLC

Organisation Mental Illness Community Based Residential Treatment Facility Fairview, OR

Practice location

Address: 1818 Fairview Ave, Fairview, OR 97024-3761
Phone: (404) 740-7257
Fax: (404) 740-7257

Authorised official

Name: Sibamo Bette Gaguro
Title: Administrator
Phone: (404) 740-7257

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Oregon →

Registry record

NPI: 1043156706
Entity type: Organization
NPI issued: 27 Apr 2026
Record last updated: 27 Apr 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.