Organization
PROFESSIONAL THERAPEUTIC COMMUNITY NETWORK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE WATSON MA (CEO)
(503) 391-7175
Entity
Organization
Contact information
Practice address
2905 RIVER RD S, SALEM, OR 97302-9754
(503) 391-7175
(503) 585-3303
Mailing address
2905 RIVER RD S, SALEM, OR 97302-9754
(503) 391-7175
(503) 585-3303
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
OR
253J00000X
Foster Care Agency
—
OR
320800000X
Mental Illness Community Based Residential Treatment Facility
—
OR
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
OR
Other
Enumeration date
11/24/2008
Last updated
05/16/2013
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