NPI 1043876865

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Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Salem, OR

Practice location

Address: 5100 Center St NE, Salem, OR 97317-3217
Phone: (503) 917-1955
Fax: (503) 990-8686

Authorised official

Name: James Matthew Conway
Title: Executive Director
Phone: (503) 917-1955

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1043876865
Entity type: Organization
NPI issued: 16 May 2019
Record last updated: 16 May 2019

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.