NPI 1396604468

Gifted Soul Residential Home LLC.

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

Practice location

Address: 1128 SE 141st Ave, Portland, OR 97233-2218
Phone: (503) 206-5980
Fax: (503) 447-4702

Authorised official

Name: Safawo Yadeto
Title: Executive Director
Phone: (360) 990-5579

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1396604468
Entity type: Organization
NPI issued: 15 Jan 2026
Record last updated: 15 Jan 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.