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Pacific Northwest Living Llc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Salem, Oregon
NPI 1225626765

Pacific Northwest Living Llc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Salem, OR. Pacific Northwest Living Llc practices in Salem, OR. The NPI Number for Pacific Northwest Living Llc is 1225626765 and holds a License No. (Oregon).

The current practice location address for Pacific Northwest Living Llc is 4392 Coloma Dr Se, Salem, OR and can be reached out via phone at 971-301-8831 and via fax at 971-301-8862.

Location: 4392 Coloma Dr Se, Salem, OR, 97302-5076
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1225626765
Provider Name
Pacific Northwest Living Llc
Credential
Provider Entity Type
Organization
Address
4392 Coloma Dr Se, Salem, OR, 97302-5076
Phone Number
971-301-8831
Fax Number
971-301-8862
Provider Enumeration Date
01/08/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
DZ1463 05 OR
DZ1463 01 OR AGENCY CERTIFICATE DEVELOPMENTAL DISABILITY
institution
Provider Business Practice Location Address Details
Address
4392 Coloma Dr Se
City
Salem
State
Oregon
Zip
97302-5076
Phone Number
971-301-8831
Fax Number
971-301-8862
person
Provider Business Mailing Address Details
Address
4392 Coloma Dr Se
City
Salem
State
Oregon
Zip
97302-5076
Phone Number
971-301-8831
Fax Number
971-301-8862
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
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Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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