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NPI 1043876865 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Salem, OR
Provider details
- NPI number
- 1043876865
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- James Conway, Executive Director(503) 917-1955
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5100 Center St Ne
Salem, OR 97317-3217
Phone: (503) 917-1955
Fax: (503) 990-8686
Street-level locationGet directions
Mailing address
5100 Center St Ne
Salem, OR 97317-3217
Registry dates
- Enumerated
- 2019-05-16
- Last updated
- 2019-05-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.