Family Residential Treatment Home
Community Based Residential Treatment Facility, Mental Illness in Salem, OR. Organization (NPI-2).
NPI number1972452159
StatusActive
Last updated in NPPESJan 22, 2026
Details
- NPI
- 1972452159
- Entity type
- Organization (NPI-2)
- Legal business name
- Family Residential Treatment Home
- Organization subpart
- No
- Enumeration date
- Jan 22, 2026
- Certification date
- Jan 22, 2026
- Last updated
- Jan 22, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – | Yes |
Practice location
4436 Jade St NeSalem, OR 97305-2233
Phone 971-258-6432
Mailing address
4436 Jade St NeSalem, OR 97305-2233
Phone 971-258-6432
Authorized official
Jennifer Dixon
Administrator
9717193141
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