Individual provider · Type 1 NPI

Tesfaye Gomalo

Mental Illness Community Based Residential Treatment Facility · Salem, OR

NPI number 1255299749 Active

Practice location

4436 Jade St NE
Salem, OR 97305-2233

Call (971) 258-6432 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Illness Community Based Residential Treatment Facility Primary 320800000XRTH100295 (OR)

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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About NPI 1255299749

Tesfaye Gomalo's National Provider Identifier is 1255299749, issued on Jan 13, 2026. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Salem, OR. The record was last updated on Jan 13, 2026.