IndividualActive
Tesfaye Gomalo
NPI 1255299749 · Mental Illness Community Based Residential Treatment Facility · Salem, OR
Provider details
- NPI number
- 1255299749
- Entity type
- Individual
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
- License
- RTH100295 (OR)
Specialties & taxonomies
- Mental Illness Community Based Residential Treatment FacilityPrimary320800000XLicense RTH100295 (OR)
Residential Treatment Facilities
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
4436 Jade St Ne
Salem, OR 97305-2233
Phone: (971) 258-6432
Street-level locationGet directions
Mailing address
4436 Jade St Ne
Salem, OR 97305-2233
Registry dates
- Enumerated
- 2026-01-13
- Last updated
- 2026-01-13
- Certified
- 2026-01-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.