Incredible Residential Services LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

INCREDIBLE RESIDENTIAL SERVICES LLC

Practice address

2246 SE 90TH Ave
Portland, OR 97216-2021

Phone

(702) 491-3964

Fax

(503) 894-8787

NPI assigned

Sep 22, 2025

Last updated

Oct 2, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gemechu Jorjore

Title

Director

Phone

(702) 491-3964

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1558233148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2246 SE 90TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162021",
            "telephone_number": "702-491-3964",
            "fax_number": "503-894-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2246 SE 90TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162021",
            "telephone_number": "702-491-3964",
            "fax_number": "503-894-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCREDIBLE RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "JORJORE",
        "authorized_official_first_name": "GEMECHU",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-491-3964"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.