PROFESSIONAL THERAPEUTIC COMMUNITY NETWORK, INC (NPI# 1629223243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629223243 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL THERAPEUTIC COMMUNITY NETWORK, INC |
| Practice Address |
2905 River Rd S Salem OR 97302-9754 |
| Practice Telephone | 5033917175 |
| Practice Fax Number | 5035853303 |
| Mailing Telephone | 5033917175 |
| Mailing Fax Number | 5035853303 |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2013-05-16 |
| Authorized Official Name | MR. JESSE WATSON (CEO) |
| Authorized Official Telephone | 5033917175 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 253J00000X | Foster Care Agency | OR | Agencies | |
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | OR | Residential Treatment Facilities | |
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | OR | Residential Treatment Facilities | |
| Y | 251S00000X | Community/Behavioral Health | OR | Agencies |
| Street Address |
2905 RIVER RD S |
| City | SALEM |
| State | OR |
| Zip Code | 97302-9754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538341219 | Britney R Seitz | Counselor | 2905 River Rd S, Salem, OR 97302-9754 | 2007-12-04 |
| 1396300497 | Patricia Joanne Myers | Counselor | 2905 River Rd S, Salem, OR 97302-9754 | 2019-05-03 |
| 1699222471 | Mara Marie Walls | Social Worker | 2905 River Rd S, Salem, OR 97302-9754 | 2016-09-08 |
| 1609321769 | Liam Abraham | Counselor | 2905 River Rd S, Salem, OR 97302-9754 | 2016-08-18 |
| 1548636079 | Professional Therapuetic Community Network | Residential Treatment Facility, Emotionally Disturbed Children | 2905 River Rd S, Salem, OR 97302-9754 | 2015-08-19 |
| 1043617988 | Cindy Webb | Counselor | 2905 River Rd S, Salem, OR 97302-9754 | 2014-11-20 |
| 1801200969 | Nacole Cavette | Counselor | 2905 River Rd S, Salem, OR 97302-9754 | 2014-06-17 |
| 1013321348 | Babak Zolfaghari-azar | Behavioral Analyst | 2905 River Rd S, Salem, OR 97302-9754 | 2014-06-14 |
| 1477967875 | Kirsten G Collins | Behavioral Analyst | 2905 River Rd S, Salem, OR 97302-9754 | 2014-06-13 |
| 1558798298 | Christa Lee Cummins | Counselor | 2905 River Rd S, Salem, OR 97302-9754 | 2013-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| 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.