Organization
FAMILY BUILDING BLOCKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN FENNIMORE LCSW (PROGRAM DIRECTOR)
(503) 566-2132
Entity
Organization
Contact information
Practice address
2425 LANCASTER DR NE, SALEM, OR 97305-1220
(503) 566-2132
Mailing address
2425 LANCASTER DR NE, SALEM, OR 97305-1220
(503) 566-2132
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/12/2020
Last updated
02/03/2026
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