OrganizationActive
Pacific Northwest Living LLC
NPI 1225626765 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Salem, OR
Provider details
- NPI number
- 1225626765
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Rosella Miltimore, Executive Director(503) 765-0454
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
4392 Coloma Dr Se
Salem, OR 97302-5076
Phone: (971) 301-8831
Fax: (971) 301-8862
Approximate (ZIP-level) locationGet directions
Mailing address
4392 Coloma Dr Se
Salem, OR 97302-5076
Other names (DBA / former)
- Doing business as
- Pacific Northwest Living LLC
Registry dates
- Enumerated
- 2021-01-08
- Last updated
- 2021-01-08
- Certified
- 2021-01-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.