Serenity Residential Treatment Home

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

SERENITY RESIDENTIAL TREATMENT HOME

Practice address

4629 Ward Dr NE # S
Salem, OR 97305-3161

Phone

(541) 860-8570

NPI assigned

Nov 21, 2025

Last updated

Dec 14, 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

Sitate Tesfaye Gelgelu

Title

Director

Phone

(541) 860-8570

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1763683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765670400000",
    "number": "1659232346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4629 WARD DR NE # S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973053161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4629 WARD DR NE # S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973053161",
            "telephone_number": "541-860-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY RESIDENTIAL TREATMENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-21",
        "last_updated": "2025-12-14",
        "certification_date": "2025-12-14",
        "status": "A",
        "authorized_official_last_name": "GELGELU",
        "authorized_official_first_name": "SITATE",
        "authorized_official_middle_name": "TESFAYE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "541-860-8570"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Salem, OR
• Providers in Salem, OR by specialty
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.