Organization
FAMILY RESIDENTIAL TREATMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER DIXON (ADMINISTRATOR)
(971) 719-3141
Entity
Organization
Contact information
Practice address
4436 JADE ST NE, SALEM, OR 97305-2233
(971) 258-6432
Mailing address
4436 JADE ST NE, SALEM, OR 97305-2233
(971) 258-6432
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/22/2026
Last updated
01/22/2026
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