TRILLIUM FAMILY SERVICES (NPI# 1336401017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336401017 |
| Entity Type | Organization |
| Organization Name | TRILLIUM FAMILY SERVICES |
| Other Organization Name | WAKE ROBIN |
| Practice Address |
1520 Plaza Street Nw Suite 100 Salem OR 97304 |
| Mailing Address |
3415 Se Powell Boulevard Portland OR 97202 |
| Practice Telephone | 5032054362 |
| Practice Fax Number | 5032050193 |
| Mailing Telephone | 5032054362 |
| Mailing Fax Number | 5032050193 |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2014-03-24 |
| Authorized Official Name | MS. SUZY K VENZKE (BILLING MANAGER) |
| Authorized Official Telephone | 5032054362 |
| Is Organization Subpart | Y |
| Parent Organization Name | TRILLIUM FAMILY SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 145946 | 05 |
| Other Name | Type Code |
|---|---|
| Wake Robin | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740733906 | Trillium Family Services | Community Based Residential Treatment Facility, Mental Illness | 4545 Ne Highway 20, Corvallis, OR 97330-9655 | 2016-07-25 |
| 1659617298 | Trillium Family Services | Community Based Residential Treatment Facility, Mental Illness | 9214 Sw Cascara Ln, Tualatin, OR 97062-7553 | 2013-01-01 |
| 1235440702 | Trillium Family Services | Psychiatric Residential Treatment Facility | 3009 Nw Grant Pl, Corvallis, OR 97330-1814 | 2010-06-29 |
| 1346494101 | Trillium Family Services | Psychiatric Residential Treatment Facility | 229 Se 4th Ave, Albany, OR 97321 | 2008-11-06 |
| 1326238809 | Trillium Family Services | Community Based Residential Treatment Facility, Mental Illness | 3830 Ne 21st Ave, Portland, OR 97212-1429 | 2007-07-31 |
| 1104026376 | Trillium Family Services | Community Based Residential Treatment Facility, Mental Illness | 792 Se Mayberry Ave, Corvallis, OR 97333-1862 | 2007-07-24 |
| 1831395375 | Trillium Family Services | Psychiatric Residential Treatment Facility | 2430 Nw Rolling Green Dr, #17, Corvallis, OR 97330-3778 | 2007-06-22 |
| 1568663078 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1505 Nw Harder Ln, Albany, OR 97321-1522 | 2007-05-31 |
| 1568663300 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 4140 Ne Highway 20, Corvallis, OR 97330-9639 | 2007-05-30 |
| 1619178829 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 4455 Highway North West Highway 20, Corvallis, OR 97333 | 2007-05-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | TRILLIUM FAMILY SERVICES FOUNDATION, INC. | 3415 Se Powell Blvd, Portland, OR 97202 |
| Oregon Corporations, Companies and Business Names | TRILLIUM FAMILY SERVICES, INC. | 3415 Se Powell Blvd, Portland, OR 97202 |
| Street Address |
1520 PLAZA STREET NW SUITE 100 |
| City | SALEM |
| State | OR |
| Zip Code | 97304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992117105 | Shelly Barr | Case Manager/Care Coordinator | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2014-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| 1992932560 | Michelle Lynn Laseter | Counselor | 290 Moyer Ln. Nw, Salem, OR 97304 | 2009-06-22 |
| Find all providers in zip 97304 | ||||
| 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.