NPIMap

Organization Active NPI

Professional Therapeutic Community Network, Inc

  • Community/Behavioral Health Agency
  • Salem, OR
National Provider Identifier
1629223243
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PROFESSIONAL THERAPEUTIC COMMUNITY NETWORK, INC
Practice address
2905 River Rd S
Salem, OR 97302-9754
Phone
(503) 391-7175
Fax
(503) 585-3303
NPI assigned
Nov 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Authorized official

Name
Mr. Jesse Watson, MANPI 1861732737
Title
Ceo
Phone
(503) 391-7175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OR Primary
Foster Care Agency 253J00000X OR
Mental Illness Community Based Residential Treatment Facility 320800000X OR
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X OR

Addresses

Primary practice location

2905 River Rd S
Salem, OR 97302-9754

Mailing address

2905 River Rd S
Salem, OR 97302-9754
Phone (503) 391-7175

National Provider Directory

National Provider Directory
Tax ID family
Professional Therapeutic Community Network Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1629223243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 RIVER RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029754",
            "telephone_number": "503-391-7175",
            "fax_number": "503-585-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 RIVER RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029754",
            "telephone_number": "503-391-7175",
            "fax_number": "503-585-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL THERAPEUTIC COMMUNITY NETWORK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-391-7175",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.