CHRISTIAN COMMUNITY PLACEMENT CENTER (NPI# 1174698971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174698971 |
| Entity Type | Organization |
| Organization Name | CHRISTIAN COMMUNITY PLACEMENT CENTER |
| Other Organization Name | CONNECTIONS365 |
| Practice Address |
4890 32nd Ave Se Salem OR 97317 |
| Practice Telephone | 5035885647 |
| Practice Fax Number | 5037791992 |
| Mailing Telephone | 5035885647 |
| Mailing Fax Number | 5035880509 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2018-05-11 |
| Authorized Official Name | DEBOHRA ANN LUTE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5035885647 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 253J00000X | Foster Care Agency | 0056 | OR | Agencies |
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | OR | Residential Treatment Facilities | |
| Y | 251S00000X | Community/Behavioral Health | OR | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 240040 | 05 |
| Other Name | Type Code |
|---|---|
| Connections365 | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3340 Commercial St Se Ste 110, Salem, OR 973023863 | 5035885647 | 5039907093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700194875 | Christian Community Placement Center | Foster Care Agency | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2010-09-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CHRISTIAN COMMUNITY PLACEMENT CENTER | 4890 32nd Ave Se, Salem, OR 97317 |
| Street Address |
4890 32ND AVE SE |
| City | SALEM |
| State | OR |
| Zip Code | 97317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205466018 | Jake Gongora | Community Health Worker | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2020-01-21 |
| 1114483773 | Michelle J Zamarron | Case Manager/Care Coordinator | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2019-02-19 |
| 1164904124 | Miguel Gonzalez | Counselor | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2018-09-05 |
| 1679051692 | Kylie Tamiko Gumban | Community Health Worker | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2018-08-01 |
| 1003392515 | Alan Keith Gustafson | Community Health Worker | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2018-07-17 |
| 1679059182 | Nancy Diane Gustafson | Community Health Worker | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2018-07-17 |
| 1639665508 | Jaremy Calderon | Case Manager/Care Coordinator | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2018-07-03 |
| 1699267542 | Alyssa Hope Rice | Community Health Worker | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2018-06-05 |
| 1437641388 | Ellen Reece | Case Manager/Care Coordinator | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2018-06-05 |
| 1548750029 | Mariah Michaela Miller | Community Health Worker | 4890 32nd Ave Se, Salem, OR 97317-9350 | 2018-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962932996 | Corinna Leona Zib | Counselor | 4726 Appaloosa Ct Se, Salem, OR 97317 | 2017-06-13 |
| 1639537889 | Nikole Stormo | Massage Therapist | 4675 Campbell Dr Se Apt267, Salem, OR 97317 | 2016-02-03 |
| 1114479128 | Jocelyn Gran | Pharmacist | 2400 Lancaster Dr Ne, Salem, OR 97317 | 2016-10-26 |
| 1841410057 | Jennifer Krug | Specialist/Technologist | 5000 Deer Park Dr Se, Salem, OR 97317 | 2007-04-27 |
| 1649498262 | Carol Adams | Social Worker | 1164 63rd Ave Ne, Salem, OR 97317-2313 | 2007-04-20 |
| 1992114490 | Pathways - Child and Family Services - LLC | Community/Behavioral Health | 1164 63rd Ave Ne, Salem, OR 97317-2313 | 2014-08-08 |
| 1417513235 | James Matthew Conway | Social Worker | 5100 Center St Ne, Salem, OR 97317-3217 | 2019-05-16 |
| 1043876865 | Home Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5100 Center St Ne, Salem, OR 97317-3217 | 2019-05-16 |
| 1689086530 | Ruben Chekhov | Dental Hygienist | 4932 Turquoise Ave Se, Salem, OR 97317-4109 | 2014-05-27 |
| 1285636464 | Marion County Fire District No 1 | Ambulance | 300 Cordon Rd Ne, Salem, OR 97317-5203 | 2005-06-01 |
| Find all providers in zip 97317 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881153948 | Pause Counseling, LLC | Community/Behavioral Health | 202 Main St Ste 102104, Salem, NH 03079-3170 | 2019-03-18 |
| 1821564436 | Bokker Enterprises, Inc. | Community/Behavioral Health | 115 Turner Lane, Ste #2, Salem, AR 72576 | 2018-10-22 |
| 1477050326 | Oregon Wellness Network | Community/Behavioral Health | 2615 Portland Rd Ne, Salem, OR 97301-0124 | 2018-04-08 |
| 1700335536 | Joel M Suckow-md, LLC | Community/Behavioral Health | 388 State St Ste 701, Salem, OR 97301 | 2016-09-21 |
| 1073979696 | Family Preservation Services, Inc | Community/Behavioral Health | 4507 Malus Dr, Salem, VA 24153-7921 | 2016-01-12 |
| 1700252954 | Acenda, Inc. | Community/Behavioral Health | 168 E Broadway, Salem, NJ 08079-1153 | 2015-08-11 |
| 1265820880 | Leumas Lighted Life, LLC | Community/Behavioral Health | 32 W Clay St, Salem, VA 24153-3754 | 2015-01-05 |
| 1982004362 | Alternative Oppurtunities | Community/Behavioral Health | 684 Sky Vu Shopping Center, Highway 412 West, Salem, AR 72576 | 2014-09-04 |
| 1245646967 | Community Alternatives Virginia, Inc. | Community/Behavioral Health | 119 Sheraton Dr, Salem, VA 24153-3003 | 2014-07-02 |
| 1417361312 | Multi-cultural Consultants, Ltd | Community/Behavioral Health | Freedom & Recovery Program, 3405 Deer Park Dr. Se, Salem, OR 97310-0001 | 2014-06-18 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.