Organization · Type 2 NPI

Family Residential Treatment Home

Mental Illness Community Based Residential Treatment Facility · Salem, OR

NPI number 1972452159 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 320800000XNone listed

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 1972452159

Family Residential Treatment Home's National Provider Identifier is 1972452159, issued on Jan 22, 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 22, 2026.